Brain tumours (intracerebral, meningioma, skull base, pituitary)

ADULT

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Symptoms of signs of raised intracranial pressure
    • Severe and increasing headache
    • Deteriorating neurological function i.e. increasing headache and/or nausea and vomiting, seizure, decreasing conscious level, the development of focal neurological signs
    • Seizures
    • Suspected glucocorticoid deficiency
    • Monitor neurological function
      • headache suspicious for raised intracranial pressure i.e. morning headache, vomiting and papilloedema and/or
      • associated neurological features i.e. new onset seizures, cognitive, behavioural or personality changes, neurological deficits
    • Concurrent endocrinology referral for all pituitary tumours not already reviewed by endocrine service
    • Concurrent ENT/otology referral for acoustic neuroma/vestibular schwannoma referrals if not already seen by ENT
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Any neurological or cranial nerve deficits
  • Clinical or imaging features suggestive of malignancy
  • Evidence of cerebral oedema or mass effect on imaging.
  • Any obvious hormonal excess or deficiency (noting that suspected glucocorticoid deficiency should be referred for Emergency assessment)
Category 2
(appointment within 90 calendar days)
  • Incidental finding on imaging with no neurological deficit e.g. non-functioning pituitary tumour, epidermoid cyst, arachnoid cyst and/or unusual pathology
Category 3
(appointment within 365 calendar days)
  • Pituitary tumours with no visual impairment, normal pituitary function and/or mild hyper-prolactinemia

Please insert the below information and minimum referral criteria into referral

1. Reason for request Indicate on the referral

  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can't order, or the patient can't afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary

2. Essential referral information Referral will be returned without this

  • History and examination findings
  • CT+/-contrast and/or MRI for patients with suspected space-occupying lesion.
  • Pituitary function tests including prolactin if suspected pituitary tumour (e.g. prolactin, random cortisol, growth hormone and IGF1, TFT's)

3. Additional referral information Useful for processing the referral

  • Details of previous malignancy including treatment/any relevant imaging results

4. Request

  • Patient's Demographic Details

    • Full name (including aliases)
    • Date of birth
    • Residential and postal address
    • Telephone contact number/s – home, mobile and alternative
    • Medicare number (where eligible)
    • Name of the parent or caregiver (if appropriate)
    • Preferred language and interpreter requirements
    • Identifies as Aboriginal and/or Torres Strait Islander

    Referring Practitioner Details

    • Full name
    • Full address
    • Contact details – telephone, fax, email
    • Provider number
    • Date of referral
    • Signature

    Relevant clinical information about the condition

    • Presenting symptoms (evolution and duration)
    • Physical findings
    • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
    • Body mass index (BMI)
    • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
    • Current medications and dosages
    • Drug allergies
    • Alcohol, tobacco and other drugs use

    Reason for request

    • To establish a diagnosis
    • For treatment or intervention
    • For advice and management
    • For specialist to take over management
    • Reassurance for GP/second opinion
    • For a specified test/investigation the GP can't order, or the patient can't afford or access
    • Reassurance for the patient/family
    • For other reason (e.g. rapidly accelerating disease progression)
    • Clinical judgement indicates a referral for specialist review is necessary

    Clinical modifiers

    • Impact on employment
    • Impact on education
    • Impact on home
    • Impact on activities of daily living
    • Impact on ability to care for others
    • Impact on personal frailty or safety
    • Identifies as Aboriginal and/or Torres Strait Islander

    Other relevant information

    • Willingness to have surgery (where surgery is a likely intervention)
    • Choice to be treated as a public or private patient
    • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)

  • If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or follow local emergency care protocols or seek emergent medical advice if in a remote region.

    • Please note that where appropriate and available, the referral may be streamed to an associated public allied health and/or nursing service. This may include initial assessment and management by associated public allied health and/or nursing, which may either expedite or negate the need to see the public medical specialist.
    • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
    • Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

Last updated: 25 February 2019

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