Early diagnosis of patients with stroke is paramount in order to achieve benefits from thrombolytic therapy. Public education, improved access to pre-hospital care and healthcare personnel along with prompt neuroimaging are some means by which care can be improved.

The transfer of head-injured patients, many with multiple injuries, is not being performed in a manner consistent with modern medical practice. There is urgent need for implementation of a standardized protocol for the transfer of such patients in Jamaica.

Neuroendoscopy is the treatment of choice for obstructive hydrocephalus due to aqueduct stenosis or posterior fossa tumours and has the advantage of avoiding shunt related complications. It is safe and effective for the majority of patients and has a significant role in the management of neurosurgical patients in the West Indies.