Six stage journey When diagnosed with a brain tumour

Onset of symptoms Initial investigations Medications may be commenced See GP, other specialist or present to emergency department Initial investigations CT scan/MRI of brain Other scans Blood tests Medications may be commenced Anti convulsants Dexamethasone Pain killers Medications may be commenced

Consultation with Neurosurgeon Probable diagnosis conveyed May need further investigations Treatment plan discussed. This may take one of the following: Surgery Watch and wait Referral to other Specialist for other Treatments Radiation Chemotherapy

Surgery Pre operative assessment Admission to hospital Entry to OR Biopsy or attempt at complete resection Pre operative assessment Anaesthetic assessment General baseline blood tests ECG, chest X ray Stereotactic navigation scan (MRI or CT) Admission to hospital Entry to OR

Post operative care General hospital stay 3-4 days First day spent in high dependency unit Second day – CT or MRI then transfer to ward On ward Encourage mobility Assessment by physio, occupational therapy, speech therapy as required Weaning of medications Prepare for discharge home – ensure appropriate supports available May need referral to inpatient or out patient rehab services

Pathology – the confirmed diagnosis This may occur whilst in hospital or in surgeon’s office after discharge. Name of tumour conveyed Education given about the expectations for the future including The need for further treatments Lifestyle changes necessary Survival expectations Referrals made to other specialists (if need be) Referrals to other health professionals and support services. Neurosurgeon’s office remains primary contact for any further queries.

Ongoing follow up This may be with Neurosurgeon Other specialist Radiation oncologist Medical oncologist ENT surgeon/other surgeon Other health professional Or all of the above