Referral to emergency

If any of the following are present or suspected, please refer the patient to the emergency department (via ambulance if necessary) or seek emergent medical advice if in a remote region.

  • collapse/seizure/altered level of consciousness/new acutely progressive neurological deficit

Please contact the on-call registrar to discuss your concerns prior to referral.

For clinical advice, please telephone the relevant metropolitan Local Health Network switchboard and ask to speak to the relevant specialty service.

Central Adelaide Local Health Network

Southern Adelaide Local Health Network

Exclusions

  • incidental, asymptomatic anatomical variants and expected degenerative changes

Triage categories

Category 1 (appointment clinically indicated within 30 days)

  • chiari malformation with hydrocephalus/syringomyelia confirmed with imaging
  • craniocervical junction abnormality with brain stem/spinal cord signal change confirmed with medical resonance imaging (MRI)
  • chiari malformation/craniocervical abnormality with sensory changes/weakness in the limbs/bladder or bowel dysfunction

Category 2 (appointment clinically indicated within 90 days)

  • abnormality of the craniocervical junction with concerning features, including:
    • abnormal reflexes
    • dizziness or vertigo
    • headaches, particularly in the back of the head
    • neck pain and stiffness

Category 3 (appointment clinically indicated within 365 days)

  • incidental chiari malformation without concerning features
  • craniocervical junction stenosis without concerning features

For more on outpatient referrals, see the general referral information page.

Essential referral information

Completion required before first appointment to ensure patients are ready for care. Please indicate in the referral if the patient is unable to access mandatory tests or investigations as they incur a cost or are unavailable locally.

  • identifies as Aboriginal and/or Torres Strait Islander  
  • relevant social history, including identifying if you feel your patient is from a vulnerable population and/or requires a third party to receive correspondence on their behalf
  • interpreter required
  • relevant past medical/surgical history
  • current medications, allergies
  • history of presenting complaint including:
    • onset
    • duration
    • concerning features
  • neurological examination findings
  • confirmation of diagnosis on imaging and associated reports including location, company, and accession number

Additional information to assist triage categorisation

  • medical resonance imaging (MRI) whole spine where possible to assess for presence of syrinx