Referral management: Which patients are deemed not appropriate for neurologic consultation, and what happens to them?

Objective: In many if not most institutions in the US, demand for neurology services exceeds the supply, resulting in poor access. This study examines whether the use of a limited resource - time for outpatient neurology consultation - can be optimized by screening referrals for appropriateness and whether it is safe to do so.

Patients And Methods: An established triage activity at an academic outpatient clinic - experienced nurses flagging possibly inappropriate outpatient referrals and a group of neurologists triaging them - was examined by obtaining referral characteristics and detailed one year follow up for patients that were referred but not scheduled, over a period of 6 months.

Do Headache Patients Require More Care in Between Visits Than Other Neurology Outpatients?

Background: There is evidence that time spent in patient care in between patient visits is increasing and a contributor to physician burnout. The extent of this work on providers in the field of headache medicine is unknown.

Objectives: To establish whether headache outpatients require a high level of care in addition to clinic visits, based on the quantity of remote encounters per patient (phone calls and secure email communication to the clinics), in comparison to other neurologic clinics.

Hemicrania continua in carotid artery dissection - symptomatic cases or linked pathophysiology?

Background Hemicrania continua (HC) -like headaches have been rarely reported as symptomatic headaches, including cases secondary to cervical artery dissection. Case series We present five cases of HC-like headaches following cervical artery dissection, in three cases with specific indomethacin response. In two cases, comorbidity of fibromuscular dysplasia (FMD) was noted.