The COVID-19 pandemic imposed a series of behavioral changes that resulted in increased social isolation and a more sedentary life for many across all age groups, but, above all, for the elderly population who are the most vulnerable to infections and chronic neurodegenerative diseases. Systemic inflammatory responses are known to accelerate neurodegenerative disease progression, which leads to permanent damage, loss of brain function, and the loss of autonomy for many aged people. During the COVID-19 pandemic, a spectrum of inflammatory responses was generated in affected individuals, and it is expected that the elderly patients with chronic neurodegenerative diseases who survived SARSCoV-2 infection, it will be found, sooner or later, that there is a worsening of their neurodegenerative conditions. Using mouse prion disease as a model for chronic neurodegeneration, we review the effects of social isolation, sedentary living, and viral infection on the disease progression with a focus on sickness behavior and on the responses of microglia and astrocytes. Focusing on aging, we discuss the cellular and molecular mechanisms related to immunosenescence in chronic neurodegenerative diseases and how infections may accelerate their progression.

Background: Post-spinal anesthesia headache is a common complication of this procedure due to the loss of cerebrospinal fluid through the puncture orifice. Resolution may be spontaneous or require interventions such as presented in this study. Objective: To address the most relevant and current aspects of post-spinal anesthesia headache treatment. Methods: Literature review based on Pubmed, Scielo and Google Scholar databases, having as inclusion criteria articles of great published in English, Portuguese and Spanish in the period 2016 to 2021 and exclusion criteria articles published outside that period. Results: Post-spinal anesthesia headache or post-dural puncture headache (DPC) is divided into disabling headache and non-disabling headache in order to guide its management. In non-disabling headache, analgesics, caffeine and hydration are used. In disabling headache, blood-patching can be performed from the injection of autologous blood in the epidural space in order to buffer the puncture hole. In addition to this technique, there is the blockade of the sphenuous- palatine ganglion, which is performed by applying 5% lidocaine with the aid of a swab, introduced perpendicularly to the nasopharynx, where the sphenuous ganglion is located – palatine ,inhibiting vasodilation from the blockage of parasympathetic transmission and thus decreasing the intensity of headache, considering the approachless invasive and with fewer complications, but that needs to be better studied for its application. Conclusion: The treatment of mistraining cppd from conservative to more invasive procedures and with a higher risk of complications. Due to the above, studies should be encouraged to expand the therapeutic arsenal of this disabling headache.

Background: Meningites are an inflammation of the meninges, more caused by virus, however, they are severe when caused by bacterias Objectives: Analyze data regarding the epidemiology of meningites in Brazil. Methods: Ecological study based on data of incidence and mortality by brazilian regions, sex and age affected by meningitis, between the year 2015 to 2020, available on Datasus. Results: In the north were reported 1.027 cases, Pará the winner; in the southeast were found 10.882 cases, and São Paulo was the most responsible; in the northeast, 12.435 cases were recorded, with the largest number in Bahia; in the South, 19.299 cases were observed, Paraná with the greatest number; finally, the midwest with 916 cases, Goiás was the winner. 8.056 deaths were reported, with the record in the southeast region, with 51,7% of total deaths, followed by the northeast (17,3%), South 16,9%), north (7,9%) and the midwest (5,9%). There was a predominance of the diasease in males (87.189 cases) over females (51.858 cases). The age groups most affected were between 20-39 years old, followed by 1-4 years old. The most affected race were whites, with 49.648 cases, followed by browns with 26.235 cases. Conclusion: The southestern region has higher mortality from meningitis and the South a higher incidence. The white race was the most affected and the age group between 20-39 years old.

Introduction. Tuberculosis (TB) is one of the ten leading causes of death worldwide and the leading cause of infection in people living with the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA). It is a major public health problem in Brazil and worldwide. Methods. This was a case series study of five meningeal tuberculosis and PLWHA coinfection patients admitted between June 2019 and June 2020, in a public hospital in the northern region of Brazil. Associated with clinical cases, we propose a discussion of the different laboratory diagnostic methods available in Brazil, with the aim of increasing the diagnosis of this very serious disease, with high mortality. Results. The diagnosis of tuberculous meningitis is a challenge in clinical practice; thus, the clinical cases presented help the physician to recognize the signs and symptoms of the disease and improve the confirmatory diagnosis through acid-alcoholic resistant bacilli techniques, molecular testing, and mycobacteria culture in the cerebrospinal fluid. Conclusion. Knowing the diagnostic methods of tuberculous meningitis and its characteristics is of paramount importance to increase the correct diagnosis and reduce mortality in delayed treatment.