NICE Red flags for a brain tumour diagnosis
GPs have very clear guidelines as to when they can request an urgent MRI scan. This means that there is parity across the NHS. These guidelines are outlined by the National Institute for Health and Clinical Excellence (NICE) and recommend the specific symptoms and the criteria required for referral.
Only 1% of people are diagnosed with a brain tumour following an urgent referral from the GP. This is not 1% of the population, but 1% of people who go to the GP with what they think are symptoms of a brain tumour. 58% of people with a brain tumour are diagnosed when they go to casualty.
|New or recent onset seizures||A seizure is what happens when there is a sudden, abnormal burst of intense electrical activity in the brain. New or recent onset seizures would prompt an urgent referral. |
|Neurological deficit which is worsening||For example, weakness, loss of sensation or numbness. |
|Headaches||These would be typically be more severe in the morning and wake you in the night. They are usually different to the headaches you may have had before. They will be persistent and worsen over time. |
|Mental changes||Mental changes refer to general changes in brain function, such as confusion, amnesia (memory loss), loss of alertness, loss of orientation (not aware of self, time, or place), defects in judgement or thought, poor regulation of emotions, and disruptions in perception, psychomotor skills, and behaviour.|
|Cranial nerve palsy||Cranial nerve palsy involves one or more of the cranial nerves. Palsy occurs when a muscle becomes paralysed or someone loses control of it, experiencing erratic muscle movements, spastic jerks, and other problems. Cranial nerve palsies are usually very easy to identify because they involve the muscles of the face, and people's faces change as a result of the palsy. A patient may find it difficult to smile, to control eye movements, and to engage in other facial expressions.|
|Unilateral sensorineural deafness||This is a type of hearing loss in which the root cause lies in the vestibulocochlear nerve (Cranial nerve VIII), the inner ear, or central processing centres of the brain. |
|Recent onset headaches ||These would need to be accompanied by vomiting, drowsiness, posture related headaches, blackouts, change in personality or memory. |
|If you have a history of cancer accompanied by these symptoms||A few cancers can spread (metastasise) to the brain. |