Imaging patients with suspected brain tumour: guidance for primary care.
The number of referrals by primary care practitioners to secondary care neurology services, particularly for headache, may be difficult to justify. Access to imaging by primary care practitioners could avoid referral without compromising patient outcomes, but the decision to refer is based on a number of complex factors. Due to the paucity of rigorous evidence in this area, available data are combined with expert opinion to offer support for GPs. The study suggests management for three levels of risk of tumour: red flags>1%; orange flags 0.1-1%; and yellow flags<0.1% but above the background population rate of 0.01%. Clinical presentations are stratified into these three groups. Important secondary causes of headache where imaging is normal should not be overlooked, and normal investigation does not eliminate the need for follow-up or appropriate management of headache.
Kernick
David P
DP
St Thomas Health Centre, Exeter. su1838@eclipse.co.uk
Ahmed
Fayyaz
F
Bahra
Anish
A
Dowson
Andrew
A
Elrington
Giles
G
Fontebasso
Manuela
M
Giffin
Nicola J
NJ
Lipscombe
Sue
S
MacGregor
Anne
A
Peatfield
Richard
R
Weatherby
Stuart
S
Whitmarsh
Tom
T
Goadsby
Peter J
PJ
D001932:Brain Neoplasms / Q000150:complications / Q000175:diagnosis*; D005194:Family Practice; D006261:Headache / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D017410:Practice Guidelines as Topic; D011364:Professional Practice; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed