PT  - JOURNAL ARTICLE
AU  - Laura T Axinte
AU  - Barnaby D Fiddes
AU  - Alastair Donaghy
AU  - Adam Whyte
AU  - Chris Allen
AU  - Stephen J Sawcer
AU  - Robert J Adam
AU  - Sybil RL Stacpoole
TI  - Experience from two decades of the Cambridge Rapid Access Neurology Clinic
AID  - 10.7861/clinmedicine.15-5-437
DP  - 2015 Oct 05
TA  - Clinical Medicine
PG  - 437--441
VI  - 15
IP  - 5
4099  - http://www.rcpjournals.org/content/15/5/437.short
4100  - http://www.rcpjournals.org/content/15/5/437.full
SO  - Clin Med2015 Oct 05; 15
AB  - 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.