TY - JOUR T1 - Imaging patients with suspected brain tumour: guidance for primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 880 LP - 885 DO - 10.3399/bjgp08X376203 VL - 58 IS - 557 AU - David P Kernick AU - Fayyaz Ahmed AU - Anish Bahra AU - Andrew Dowson AU - Giles Elrington AU - Manuela Fontebasso AU - Nicola J Giffin AU - Sue Lipscombe AU - Anne MacGregor AU - Richard Peatfield AU - Stuart Weatherby AU - Tom Whitmarsh AU - Peter J Goadsby Y1 - 2008/12/01 UR - http://bjgp.org/content/58/557/880.abstract N2 - 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. ER -