Curriculum

The Headache Medicine Fellowship at Cincinnati Children’s aims to provide advanced training in the pathophysiology, recognition, management and study of pediatric headache disorders. Fellows leave our program with the skills and knowledge to launch careers in academic headache medicine.

Program Overview

Our curriculum involves three major components: clinical, education and research.

• The clinical exposure component includes experience in the Cincinnati Children’s Headache Center and in the University of Cincinnati Adult Headache Center, as well as at a community-based headache specialty clinics. This latter component provides ample opportunity to learn unique strategies in treating adults with intractable headaches, as well as different pharmaceutical management techniques. 
• The educational component is a combination of self-directed and traditional course work, both through the University of Cincinnati and Cincinnati Children’s. This course is designed to augment the development of research projects and will include epidemiology, biostatistics and bioethics. Fellows are also encouraged to provide lectures on various headache topics throughout their fellowship to multiple groups including pediatric residents, neurology residents, pain fellows, sports medicine fellows and PM&R fellows.
• Fellows’ research projects will be directed by their interests, but may include topics in pathophysiology, neuroimaging, disease phenotyping and characterization, treatment response, disability, and epidemiology. Currently, some of these projects are funded (headache genomics and pharmaceutical studies) while many are undergoing development with potential grant funding in the future.

Core Curriculum

Our program is designed to prepare physicians to master the art of caring for headache patients and be able to practice independently. The core curriculum is a formal and organized set of objectives focused on teaching the minimum basic knowledge required for adequate practice of headache medicine in outpatient and inpatient clinical practice. It includes the following core components: basic science, clinical practice, education and training, and clinical research. Fellows are required to obtain competencies in the six areas as defined by the Accreditation Council for Graduate Medical Education (ACGME). 

The core curriculum will address the following concepts:

• The epidemiology and pathophysiology of subtypes of head pain including primary headache disorders including migraine, tension-type, cluster headache and trigeminal neuralgia.
• The diagnosis, classification, management, and treatment of headache based on the ICHD-3 criteria established by the International Headache Society.
• Secondary or symptomatic headache disorders and understanding unique presentation of idiopathic intracranial hypertension, traumatic head injuries and brain tumors.
• Co-morbid conditions associated with headache conditions such mood disorders, asthma and other chronic pain syndromes such as fibromyalgia.

Curriculum Topics

1. Classification, Epidemiology and Mechanisms
• Overview of Diagnosis and Classification of Headache Disorders
• Epidemiology of headache disorders and impact
• Neuroimaging and other diagnostics testing
• Genetics of primary headache
2. Diagnosis and Treatment of Primary Headache Disorders
• Migraine Diagnosis
• Migraine Treatment
• Tension-type Headache
• Chronic Daily Headache including chronic migraine, tension-type headache and medication overuse headache
• Trigeminal Autonomic Cephalalgias Diagnosis and Management
• Other primary headaches
3. Diagnosis and Treatment of Secondary Headache Disorders
• Headaches Associated with Head Trauma
• Headaches Associated with Vascular Disorders
• Headaches Associated with Abnormalities Intracranial Structure such as Low-pressure
• headaches, High-pressure headaches
• Infections, Toxic and Metabolic Headaches
• Cervicogenic Headaches
• Cranial neuralgias and other causes of facial pain
4. Special Topics
• Headaches in Women
• Headaches in the Young Adult population and Transition into Adult Headache Specialty Care
• Behavioral Management of Headache
• Emergency Headache including Thunderclap Headache
• Peripheral Procedures: Nerve Blocks, Peripheral Neurostimulation, and Botulinum Neurotoxin injection