Probability of underlying tumour >1%. Investigate urgently.
- Focal neurology
- Significant alterations in consciousness
- Memory loss or confusion
- Co-ordination problems
- Known cancer
Probability of underlying tumour: 0.1 – 1%. Monitor carefully and have low threshold for investigation. However, if continue with no change in signs/symptoms for >12 weeks, rarely due to tumour.
- New headache with no diagnostic pattern after 8 weeks.
- Abnormal findings on neurological examination, or other neurological symptoms. Doesn’t that count as ‘focal neurology’? I’m confused.
- Headache aggravated by exertion/Valsalva manoeuvre
- Headaches associated with vomiting (wouldn’t this include most migraines?)
- Significant change in longstanding headache problem – esp. rapid increase in frequency
- New-onset headache in patient >50 yrs
- Headaches that wake from sleep
(Pulse on-line learning module)