Table 1.

Diverse presentations: clinical small vessel disease encounters with general and specialist services.

Clinical service	Presenting symptoms
General practitioner	All below presentations + informant reports of altered behavior, deteriorating cognition and function
Physiotherapist	Deteriorating mobility, falls
Speech and language therapist	Dysphagia, dysarthria
Occupational therapist	Functional decline requiring social support
Geriatric medicine service∗	Inpatient admissions including unexplained falls, gait deterioration, delirium +/– obvious precipitant, stroke, functional and cognitive declineFalls clinicsParkinson's disease clinicsDay hospital and rehabilitationDementia clinicsResidential and nursing home assessments
Stroke service∗	Stroke, transient ischaemic attacks, transient neurological attacks
Neurology service∗	Stroke, transient neurological attacks, cognitive assessment clinics, referrals for declining mobility, Parkinson's disease, pseudobulbar palsy
Psychiatry service∗	Dementia clinics: cognitive impairment diagnosis, management of behavioral and psychological symptoms of dementiaMood and personality changesSevere or persistent unexplained delirium
Urology/gynecology	Urinary symptoms
Accident and Emergency∗	Falls, delirium, acute neurological symptoms including stroke
Acute medical assessment unit and General internal medicine∗	Acute neurological symptoms including stroke, falls, delirium
Orthopedic serviceOsteoporosis service	Falls resulting in fractures

^∗Services with readily available access to neuroimaging investigations.