Experience from two decades of the Cambridge Rapid Access Neurology Clinic

We report on the evolution of the rapid access neurology clinic (established in 1995) at Addenbrooke’s Hospital, Cambridge. Annualised attendance data demonstrate an ever increasing demand, with primary headache disorders now accounting for more than 40% of referrals. Secondary causes of headache (i...

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Bibliographic Details
Published in:	Clinical medicine (London, England) Vol. 15; no. 5; pp. 437 - 441
Main Authors:	Axinte, Laura T, Fiddes, Barnaby D, Donaghy, Alastair, Whyte, Adam, Allen, Chris, Sawcer, Stephen J, Adam, Robert J, Stacpoole, Sybil RL
Format:	Journal Article
Language:	English
Published:	England Elsevier Ltd 01-10-2015 Royal College of Physicians
Subjects:	Acute neurology Ambulatory Care Headache - etiology headaches Humans Nervous System Diseases - therapy Original Research Outpatient Clinics, Hospital - trends rapid access United Kingdom headaches rapid access Acute neurology
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Summary:	We report on the evolution of the rapid access neurology clinic (established in 1995) at Addenbrooke’s Hospital, Cambridge. Annualised attendance data demonstrate an ever increasing demand, with primary headache disorders now accounting for more than 40% of referrals. Secondary causes of headache (including intracranial tumours, idiopathic intracranial hypertension, carotid or vertebral artery dissection and subdural haematomas) remain infrequent. In all such cases, there were additional diagnostic clues. The number of patients referred with problems related to chronic neurological diseases has fallen considerably, reflecting the roles of specialist nurses and clinics. Imaging investigation of choice shifted from computerised tomography scan (45 to 16%) towards magnetic resonance imaging (17 to 47%). Management is increasingly on an outpatient basis, often without the need for a follow-up appointment. The experience presented here should inform further development of rapid access neurology clinics across the UK and suggests the need for acute headache services, in line with those for transient ischaemic attack and first seizure.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1470-2118 1473-4893
DOI:	10.7861/clinmedicine.15-5-437