RT Journal Article
SR Electronic
T1 Imaging patients with suspected brain tumour: guidance for primary care
JF British Journal of General Practice
JO Br J Gen Pract
FD British Journal of General Practice
SP 880
OP 885
DO 10.3399/bjgp08X376203
VO 58
IS 557
A1 David P Kernick
A1 Fayyaz Ahmed
A1 Anish Bahra
A1 Andrew Dowson
A1 Giles Elrington
A1 Manuela Fontebasso
A1 Nicola J Giffin
A1 Sue Lipscombe
A1 Anne MacGregor
A1 Richard Peatfield
A1 Stuart Weatherby
A1 Tom Whitmarsh
A1 Peter J Goadsby
YR 2008
UL http://bjgp.org/content/58/557/880.abstract
AB 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.