The purpose of this article is to report the case of a 53-year-old black man, with no previous comorbidities, who presented 48 days after a confirmed diagnosis of COVID-19, complaining of an initially insidious epigastric pain that had progressed to severe pain radiating to the interscapular vertebral region, with hyporexia and episodes of projectile vomiting, with no nausea or fever. Laboratory tests revealed no signs of acute infection or pancreatic injury. Abdominal computed tomography showed dilated, fluid-filled small bowel loops with thickened walls. After clinical treatment, the patient developed persistent abdominal pain. An exploratory laparotomy was performed, finding two sites of small bowel stenosis, with no extrinsic cause, and signs of local ischemia and considerable distension of jejunal and ileal loops. After enterectomy and side-to-side enteroanastomosis, the patient recovered satisfactorily and was discharged with a prescription for oral anticoagulants for outpatient use.

Case presentation: A 10-year-old male patient was admitted due to posterior cervicalgia, vomiting and progressive generalized weakness. Physical examination showed difficulty in ambulation and tetraparesis. Magnetic resonance imaging (MRI) of the cervical medulla enhanced by the contrast agent, gadolinium, showed a poorly contrasted mass with a hemorrhagic center. We undertook a posterior cervicotomy (C1-C3). Post-operative evolution was satisfactory with complete regression of the deficits 90 days after surgery. Control MRI at intervals of 1 and 4 years confirmed absence of the tumor. Discussion: Cavernomas are vascular malformations, consisting of coarsely dilated vascular channels and coated by a single layer of endothelial cells, devoid of endothelium and myothelium. They represent only 5-12% of all vascular pathologies of the medulla, with only 10% affecting the pediatric population. There are only thirty cases of pediatric intramedullary spinal cavernomas in the literature, with predominance among males (2.1:1). Thoracic and cervical spinal cavernomas consist in 55% and 45% of the cases, respectively. In six cases (20%) cavernomatous lesions were associated with synchronic intracranial cavernoma. Among the reported cases, only one had poor evolution after surgery, whereas six patients persisted with prior symptoms. Conclusion: Spinal intramedullary cavernomas are rare entities, especially in the pediatric population, and are treated with surgery which improves prior neurologic deficits, besides preventing rebleeding

Introduction: Flavonoids have received an increasing attention from the scientific community in the last decade due to its antioxidant and anti-inflammatory effects, showing benefits in various conditions, including major depression in animal models. The aim of this study was to review the evidence produced in the last 10 years regarding the antidepressant, antioxidant and anti-inflammatory effect of flavonoids in rodent models of depression. Material and methods: It was performed a systematic review to gather articles published between 2009 and 2019 that evaluate those effects of flavonoids in rodent models of depression. Results: 43 studies were included in the review. The most frequently studied flavonoids were hesperidin (14%) and baicalin (9%). The major natural source of flavonoids were citrus fruits (19%) and Scutellaria baicalensis Georgi (9%).  Mice were used in the majority of the studies (86%). The majority of the studies did not use a specific model of depression (40%), and the most frequently used one was Chronic Unpredictable Mild Stress (21%). The most frequently used behavioral tests were forced swim test (81%), tail suspension test (56%) and open field test (51%). Discussion: Considering total tests, 93% of them presented an antidepressant activity, and all the studies that evaluated oxidative stress (37%) and inflammation (39%) found a significant antioxidant and anti-inflammatory result, respectively. Conclusions: Those findings demonstrate that the antidepressant, antioxidant and anti-inflammatory effects of flavonoids that were already evidenced in the study of other pathological conditions are also present in rodent depression models.

ABSTRACT. Creutzfeldt-Jakob disease (CJD) is one of the transmissible spongiform encephalopathies that lead to rapidly progressive dementia. CJD has a low prevalence, and the average survival is only 1 year after the onset of symptoms. As the patients with CJD develop rapidly progressive dementia, associated with myoclonus, visual or cerebellar problems, pyramidal or extrapyramidal features, and akinetic mutism, the hypothesis of CJD must be raised. Classic magnetic resonance imaging (MRI) findings are hypersignals in the caudate nucleus, putamen, and cortical region. CJD must be considered a differential diagnosis of other types of dementia, and there is no effective treatment for this disease. In this article, we present a literature review based on the report of three cases of the sporadic form of this disease.

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Case presentation: A 36-year-old male presented with moderate, progressive headache, in the left temporal region, irradiating to the ipsilateral frontal region, with several months of evolution, refractory to analgesic medication, including opioids. He reported a closed traumatic brain injury (TBI) 5 years before in a motorcycle collision with an automobile, without a helmet. At the physical examination, it was possible to verify a pulsatile mass measuring 1.5 cm in diameter, with fremitus, in the left temporal region. The magnetic resonance imaging scan presented a round lesion, encapsulated, on the course of the superficial temporal artery (STA). The digital subtraction angiography confirmed the diagnosis of STA pseudoaneurysm. A surgical resection of the aneurysm was performed, leading to the complete resolution of the headache. Discussion: The STA pseudoaneurysm is a rare condition, representing less than 1% of aneurysms, usually presenting as a late complication of TBI. The majority of cases are asymptomatic, although focal symptoms and even bleeding may occur. The presentation with a chronic refractory headache is exceptional. Its treatment is indicated for local symptom resolution, aesthetic purposes, and rupture prevention, done by clipping and resection of the pseudoaneurysm. Conclusion: Even though unusual, the awareness of this condition is important for the etiological diagnosis of a persistent temporal headache in a patient with a history of TBI.

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