Hydrocephalus and VP shunt

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
    • Increasing severity of headache
    • Deteriorating neurological function i.e. increasing headache and/or nausea and vomiting, seizure, decreasing conscious level, the development of focal neurological signs, tenderness, redness and/or swelling along shunt tract
    • Seizures
    • Swelling pain or redness along shunt tract
    • Abdominal pain or swelling
    • Clinical suspicion of shunt infection
    • Consider neurology referral for initial treatment of Idiopathic intracranial hypertension, including medical therapy and lumbar puncture:
      • suggestive symptoms, in the context of ‘normal’ cerebral imaging including MRI: morning headache, vomiting and papilloedema
      • associated neurological features i.e. new onset seizures, cognitive, behavioural or personality changes, neurological deficits
Minimum Referral Criteria
Category 1
(appointment within 30 calendar days)
  • Previously diagnosed hydrocephalus, with symptoms
  • New diagnosis of hydrocephalus on CT or MRI
  • Patient with complications or suspected complications of an in situ VP shunt
  • Idiopathic intracranial hypertension – in patients with persistent symptoms or visual deterioration despite medical therapy including repeat lumbar punctures
Category 2
(appointment within 90 calendar days)
  • Normal pressure hydrocephalus
Category 3
(appointment within 365 calendar days)
  • Routine review of VP shunt in an asymptomatic patient

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

  • CT/CTA and/or MRI results

3. Additional referral information Useful for processing the referral

  • Details of previous treatment
  • Details of findings on lumbar puncture including opening pressure
  • Ophthalmology findings including visual fields and fundoscopy.

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: 1 March 2019

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