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Table 2 (From 2005 guidelines [3])

From: Urgent referral for suspected CNS cancer: which clinical features are associated with a positive predictive value of 3 % or more?

Refer urgently patients with:
 • symptoms related to the CNS, including:
  - progressive neurological deficit
  - new-onset seizures
  - headaches
  - mental changes
  - cranial nerve palsy
  - unilateral sensorineural deafness
    in whom a brain tumour is suspected
 • headaches of recent onset accompanied by features suggestive of raised intracranial pressure, for example:
  - vomiting
  - drowsiness
  - posture-related headache
  - pulse-synchronous tinnitus
    or by other focal or non-focal neurological symptoms, for example blackout, change in personality or memory
 • a new, qualitatively different, unexplained headache that becomes progressively severe
 • suspected recent-onset seizures (refer to neurologist)
Consider urgent referral (to an appropriate specialist) in patients with rapid progression of:
 • subacute focal neurological deficit
 • unexplained cognitive impairment, behavioural disturbance or slowness, or a combination of these
 • personality changes confirmed by a witness and for which there is no reasonable explanation even in the absence of other symptoms and signs of a brain tumour