Heredofamilial neurological syndromes in Trinidad and Tobago - abstract

The only report in the literature of heredofamilial neurological syndromes (HNS) in Trinidad and Tobago was Beaubrun's study of Huntington's chorea (Beaubrun, 1965). This study of HNS in Trinidad and Tobago comprised all patients seen at the Port-of-Spain General Hospital (1980 - mid 1985), the San Fernando General Hospital (mid 1985 - 1989), together with those seen in private practice. The diagnosis and genealogy were verified. A wide variety of HNS was encountered and included amyotrophic lateral sclerosis [4 cases in 2 generations] olivopontocerebellar degeneration [9 in 3 generations], multiple sclerosis [2 in 2 generations], neurofibromatosis [3 in 3 generations], Crouzon's syndrome [2 in 3 generations], biparietal foramina [17 in 3 generations], a neurological syndrome referred to as "ptosis plus syndrome" [9 in 3 generations] and familial tremor [4 in 2 generations]. In addition there were 2 siblings each with cerebral gliomas and intracranial meningioma with familial occurrence of seizures, many cases of carpal tunnel syndrome in 1 family, and familial cases of Huntington's chorea. Mode of genetic transmission seemed to be autosomal dominant in all pedigrees, sometimes with incomplete penetrance or expressivity (AU)

A neurosurgical profile - abstract

Neurosurgical disease patterns, trends and workload in a hospital with 30 years' neurosurgical experience, serving a population of 1/3 milion were studied to assess, provide guidelines for more cost-effective patient care and to provide data for the development of neurosurgical facilities in developing areas. At the San Fernando General hospital, Trinidad, 1979-1988, there was a general increase in total hospital admissions (approximately 48,000/yr), neurosurgical admissions (73 to 161/yr), transfers to the neurosurgical unit (39 to 76/yr), new clinic patients (170 to 269/yr), consultations (181 to 351/yr), neuro-radiological procedures (44 to 105/yr), and surgical procedures (32 to 140 yr). There was an increase in bed occupancy rate (68 percent to 87 percent) and a reduction in the length of stay per patient (16 to 11 days), and in deaths (from a peak of 20 to 13/yr). There was a decrease in invasive studies with the advent of computerized axial tomographic scanning and magnetic resonance imaging, and myelograms showed a sharp rise due in part to newer water soluble contrast media. Surgical procedures showed a trend to more definite cranial surgery with a sharp rise in spinal surgery - laminectomy. There was and increase in the relative value score and factor which take case complesity into consideration. The commonest condition was head trauma followed by cervical spondylosis, brain tumours, seizures, spinal fractures, herniated lumbar disc, hydrocephalus and congenital anomalies and spinal tumours (AU)