Referral to emergency

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

  • collapse/seizure/altered level of consciousness/new neurological deficit
  • symptoms or signs of raised intracranial pressure which may include:
    • severe and increasing headaches
    • headaches worse in the morning
    • headache exacerbated by coughing, sneezing, straining or bending forwards
    • papilloedema
    • pulsatile tinnitus
    • visual symptoms including transient reduction in vision with straining

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Category 1 (appointment clinically indicated within 30 days)

  • intracerebral space-occupying lesion with minimal and/or slowly progressing symptoms of less than 3 months duration, confirmed with imaging
  • suspected glioma, confirmed with imaging
  • pituitary tumour associated with visual field deficits,
    • and/or symptomatic hyper-pituitarism
    • and/or hypo-pituitarism

Category 2 (appointment clinically indicated within 90 days)

  • confirmed intracerebral space-occupying lesion with minimal and/or slowly progressing symptoms greater than 3 months duration
  • incidental, asymptomatic dural based lesions without oedema
  • pituitary tumours with normal pituitary function and/or mild hyper-prolactinaemia, not causing visual impairment

Category 3 (appointment clinically indicated within 365 days)

  • nil

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. 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.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • relevant past medical/surgical history
  • current medications, allergies
  • history of presenting complaint including:
    • onset
    • duration
    • concerning features
  • neurological examination findings
  • confirmation of diagnosis on imaging and associated reports including location, company, and accession number

suspected/confirmed pituitary lesions require the following additional investigations:

  • optometrist assessment/report
  • pathology tests:
    • prolactin
    • random cortisol
    • growth hormone
    • insulin like growth factor 1 (IGF1)
    • thyroid function tests 

Additional information to assist triage categorisation

  • patients with a significant risk of metastasis / known malignancy please consider:
    • chest/abdomen/pelvis computed tomography (CT) - for staging purposes
  • referral to endocrinology and ophthalmology for concurrent assessment of patients with pituitary region lesions on imaging