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[Alpetragius]

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[deathmerchant]

Good evening guys

I just started a neurohospitalist job in a small community hospital and I found out that our radiologists either read those studies late or wrong especially overnight.

I have been trying to learn those CTAs but I still struggle with them.

Any good resources or courses on how to learn those ?

Working as a neurohospitalist without being comfortable with CTAs is dangerous. I mean that's like half of neurology residency. Its not complicated but it does take a lot of practice. I would review vascular anatomy and search through some online cases for eg. on radiopaedia.

 

[Jim Manderin]

Good evening guys

I just started a neurohospitalist job in a small community hospital and I found out that our radiologists either read those studies late or wrong especially overnight.

I have been trying to learn those CTAs but I still struggle with them.

Any good resources or courses on how to learn those ?

Check out aspectsinstroke.com. They have modules on mCTA reading.

 

[Telamir]

I found that what helped me the most at CTAs is basically just "reps". Read a ton of them (which I'm sure you're doing).

But also: Keep in mind you have the benefit of "clinical correlation". If you know which vascular territory you're going to be looking at that also helps you hone into that area for the most part.

You need to be organized and develop a process for looking at images. For example I typically look at axials, followed by coronals, followed by sagittal images. I look at carotid—>MCA—>M3/small branches, starting at which side I think is symptomatic. Take a cursory look at the ACAs if the symptoms might be referable to that area. After the anterior circulation I look at PCAs followed by basilar artery down to the verts/PICAs. Then I’ll go down and look at the neck if there’s no LVO or high grade stenosis in the head.

You need to look at a ton of images and you need to have a process that you do not deviate from, especially as you’re getting comfortable with it. The time for this was training, but it is what it is and I commend you for trying to improve your skills.

Also, find a radiologist you trust during the day shift and go down to radiology and go through a patient’s scan with them. They’re generally very approachable and so long as you have a question they will go through the scan with you.

 

[CnsCrit]

When I was a PGY2 there was a website called headneckbrainspine.com which singlehandedly made me feel comfortable reading CTAs in real time and identifying LVOs. Unfortunately the site has been down for a few years but you can still access the modules by following these directions: headneckbrainspine workaround. I'd highly recommend taking a look, as it allows you to identify vascular anatomy by scrolling the same way you would in the real world with immediate feedback. For other routine pathologies that come up on CTAs - things like identifying carotid webs, dissections, moya moya, whatever - you'll learn as you go if you take the time to stop and do a little research/googling. Radiopedia is great, and I'd agree with reviewing with neurorads whenever you have the time. The key is practice. If you make a habit of reading every scan you order, you'll start to get comfortable surprisingly quickly.

 

[WhereMyLiberalsAt]

Unfortunately the site has been down for a few years but you can still access the modules by following these directions: headneckbrainspine workaround.

So I followed the directions. Entered in my SSN and now I’m just waiting back for technical support to verify my account. They said once they receive the $1000 Amazon gift card, they’ll give me a $2000 Amazon gift card and life time access to the modules. Freaking robbing them blind!