Primary Care have direct open access to CT head and MR lumbar spine only
Please note patients may be imaged with CT or MRI, depending on indication, clinical urgency and availability of CT and MRI resources
This service is now available on Gateway at DCN (WGH) and CT scanning at St John’s
WGH – Neuroradiology
SJH – Clinical Radiology
HEAD IMAGING*
| INDICATION | AVAILABLE INVESTIGATION | NOTES |
|---|---|---|
| Headache | CT | Referral for CT may be appropriate in advance of or in conjunction with secondary care referral. See algorithm for specific advice. |
| Seizures | All patients with new onset seizures should be referred. See Epilepsy home. MR brain is usually the investigation of choice as CT misses many causes of epilepsy. It is therefore best not to make an imaging referral for CT Head at the same time as a referral for a clinical opinion | |
| Dementia & Memory problem | CT | 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. |
| Stroke or Multiple TIA | The Neurovascular clinic at the Western General Hospital offers a “one-stop” rapid clinical service. All imaging is performed on the day of attendance at the clinic and therefore separate imaging referral should not be required. | |
| Sciatica with no adverse features (see below) | MRI (CT) | Please use NHSLIntegratedBackPainPathway.aspx |
| Back pain and / or sciatica pain with adverse features | MRI (CT) | Imaging should not delay urgent specialist referral. Adverse features include onset 55yrs, associated gait or sphincter disturbance, saddle anaesthesia, severe or progressive motor loss, widespread neurological deficit, systemically unwell, known malignancy, HIV, weight loss, iv drug abuse, steroids, structural deformity, non-mechanical pain |
| Suspected spinal stenosis | CT (MRI) | Imaging should not delay urgent specialist referral if adverse features are present |
*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, Western General Hospital.
