1. Six stage journey
When diagnosed
with a brain tumour

2. 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

3. 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

4. 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

5. 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

6. 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.

7. 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