A Neuroradiology Pathway
Please note – There are 2 Open Access CT Head Pathways on SCI Gateway.
1.WGH> Neuroradiology > LI Headache suspect brain cancer
OR
2.(Edinburgh, East, Mid Lothian) WGH> Neuroradiology > LI Neuroradiology
(West Lothian) SJH> Clinical Radiology > LI CT Head LI Neuroradiology
This pathway is for guidance where routine CT is indicated (please see table below). This pathway (and page) is not for patients who require urgent CT Head for “Headache Plus” AKA Headache Suspicious of Cancer. In those cases, please see the separate pathway outlined here: Brain and Central Nervous System Cancers including Headache PLUS
Please note that for this pathway (Chronic Headache or Memory Issues) Edinburgh, East and Mid Referrals DCN is now based at the RIE, however the referrals should still be sent to the WGH until the pathway has been updated on SCI Gateway. When this changes this webpage will be updated and all GPs will be informed by email.
In many cases neuroradiological investigation complements neurosurgical or neurological opinion and should not replace clinical referral. A number of neurological symptoms may be better imaged following clinical review and/or other investigation (e.g. sensorineural deafness, acute / subacute visual failure, acute confusion, stroke). If there is uncertainty as to whether and what imaging is appropriate, and how urgently this should be performed, the Duty Consultant Neuroradiologist can be contacted via the Department of Neuroradiology, DCN (RIE).
SG & JB 8/1/26
| INDICATION | AVAILABLE INVESTIGATION | NOTES |
| Chronic Headache | CT HEAD | Referral for CT may be appropriate in advance of or in conjunction with secondary care referral. See advice on Headache page or Brain and Central Nervous System Cancers including Headache PLUS. Referrers should be mindful that: incidental finding (10%) vs. relevant finding (<0.5%); radiation dose is over 100 chest x-rays; and studies suggest it doesn’t provide long-lasting reassurance. |
| Seizures | Not appropriate for Primary Care referral | All patients with new onset seizures should be referred as per guidance on the First Seizures and Epilepsy page. |
| Dementia & Memory problem | CT HEAD | If early, rapid onset, or unusual features to exclude tumour, hydrocephalus or other intracranial mass it may be reasonable to request CT Head at the same time as referring to secondary care. See Cognitive Difficulties. |
| Stroke or Multiple TIA | Not appropriate for Primary Care referral | The TIA/Stroke Clinics offers “one-stop” rapid clinical service. If appropriate Imaging will be arranged as part of their assessment. See TIA / Stroke page. |
How to refer:
Using SCI Gateway:
- (Edinburgh, East, Mid Lothian) WGH> Neuroradiology > LI Neuroradiology then Select CT Head from Dropdown menu
- (West Lothian) SJH> Clinical Radiology > LI CT Head
Please note that for this pathway (Chronic Headache or Memory Issues) Edinburgh, East and Mid Referrals DCN is now based at the RIE, however the referrals should still be sent to the WGH until the pathway has been updated on SCI Gateway. When this changes this webpage will be updated and all GPs will be informed by email.
