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+ 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/altered level of consciousness/new neurological deficit
  • Suspected subarachnoid haemorrhage or other intracranial haemorrhage
  • Headache with Red flags:
    • sudden onset/thunderclap headache
    • severe headache with signs of systemic illness (fever, neck stiffness,
    • vomiting, confusion, drowsiness)
    • first severe headache age over 50 years
    • severe headache associated with recent head trauma
  • Symptomatic benign or malignant space-occupying lesion
  • Suspected or proven blocked or infected VP shunt
  • Acute hydrocephalus
  • Head injuries/trauma including extensive scalp laceration or suspected traumatic brain injury
  • Trigeminal neuralgia – severe uncontrollable pain

Spine, Neck, Back Pain

NB: contact the Orthopaedic Registrar on 3810 1111. For Neurosurgery and Spine conditions please call the Neurology or Spinal Registrar at The Princess Alexandra Hospital on 3176 2111

  • High risk of irreversible deficit if not assessed urgently
  • Spinal infections
  • Significant spinal nerve root compression or spinal cord compression with progressive neurological signs/symptoms e.g.
    • Spinal cord compression with severe or rapidly progressing neurological deficit
    • Cauda equina syndrome
      • Bilateral nerve pain (leg pain below knees)
      • Bladder / bowel dysfunction
      • Perineal anaesthesia
      • Progressive weakness
    • Bone infection


  • Benign or malignant space occupying lesion associated with midline shift, hydrocephalus, neurological or endocrine deficit
  • Acute hydrocephalus
  • Suspected or proven blocked or infected vp shunt
  • Vascular disorders – suspected subarachnoid haemorrhage or other intracranial haemorrhage e.g. Thunderclap headache, collapse/altered level of consciousness, headache with vomiting, new neurological deficit
  • Cranial trauma – extradural, subdural haematoma, large cerebral contusion, concussion injuries, diffuse axonal injury, skull fractures, CSF fistula/leakage spinal trauma or other spinal conditions with severe or rapidly progressive deficit e.g. Loss of sensation, muscular weakness or cauda equina syndrome
  • Generalised seizures, prolonged focal seizures and persistent neurological deficits

+ Are you referring to the right service?

Please refer patients with:

  • Pituitary tumours to Endocrinology Department . The referral will be forwarded to Neurosurgery if appropriate for surgery. 

Neurosurgery is not serviced by West Moreton Health, please refer to Metro South Health Service

+ Out of scope services

The following are not routinely provided in a public Neurosurgery service.


  • Chronic neck and back pain with degenerative changes on imaging and no neurological abnormality on examination
    • chronic pain is defined as any pain lasting more than 6 months. Back and neck chronic pain – degenerative changes nil acute neurology
  • Non-specific headache without red flags or requiring surgical intervention


  • Positional plagiocephaly/moulding – refer paediatric plastic and reconstructive surgery at LCCH

+ Notes

  • Please note that where appropriate and where available, the referral may be streamed to an associated public allied health and/or nursing service. Access to some specific services may include initial assessment and management by associated public allied health and/or nursing, which may either facilitate or negate the need to see the public medical specialist.
  • A change in patient circumstance (such as condition deteriorating, or becoming pregnant) may affect the urgency categorisation and should be communicated as soon as possible.
  • 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.

Out of catchment

West Moreton Health is responsible for providing a public health service to people who reside within its catchment area. To appropriately manage demand for service we do not accept referrals from outside this catchment area. If your patient does live outside the West Moreton Health area and it is deemed socially or clinically necessary for their care to be received in the West Moreton Health Service, inclusion of information regarding their particular medical and/or social factors will assist with the triaging of your referral.


To provide feedback about contents on this website or general referral questions please email or phone 3413 7402.

Last updated: Monday, August 13, 2018