Cryptococcal Meningitis (CM) is a rare infection in immunocompetent patients. A kind of central nervous system infection caused by encapsulated yeast-like fungus Cryptococcus neoformans. A 59-year-old man presented to the Neurology Department of Nova Iguacu General Hospital, complaining has felt "muddled" recently and feeling diaphragmatic spasm without any apparent cause. In addition, at neurological examination, the patient was slightly confused and during the mini-mental state examination he scored less than 20 points, feeling "slowed down", no cranial nerve dysfunction, "rigidity of gait as well as of hand movements, more pronounced on the right one, pyramidal signs bilaterally were more intensely noted on the left". His MRI, lumbar puncture, fungal isolation and Nakin Ink were positive to Cryptococcosis while, in turn, HIV tests I and II were both negative. The treatment was started with Amphotericin B 50 mg IV, once a day, plus Dexamethashone. From our clinical case, we decided to do a brief review about Cryptococcoal Meningitis in immunocompetents and Cryptococcoma, researching at MedLine and Pubmed, using terms "Cryptococcal meningitis", "Cryptococcal meningitis in immunocompetent" and "Cryptococcomas". It is concluded that CM in immunocompetents is uncommon, but an important cause of non-acute meningitis, that should be included in the range of causes of preventable blindness. In this sense, this article purposes advertise clinicians and specialists, to recognize the clinical manifestation and diagnosis of cryptococcal meningitis in immunocompetents, trying to avoid a later diagnosis and the following complications.

Introduction: Acute anterior poliomyelitis (AAP) can affect people of any age, despite being uncommon before six months. The viral invasion destroys the lower motor neurons of the spinal cord, brain, and brainstem. As a result, it leads to partial or complete flaccid and asymmetrical paralysis of the lower limb and spine muscles. Big names like Frida Kahlo and US President Franklin D Roosevelt were diagnosed with polio. Case Report: We present the case of a patient with AAP diagnosed at two years of age. As an adult, he gave osteomyoarticular sequelae, insomnia, new central (adynamia), peripheral fatigue, cold intolerance, joint and neuropathic pain. The patient received a clinical diagnosis of post-polio syndrome (PPS) after fulfilling Dalakas criteria. The physical examination showed some hallmarks of AAP, in addition to those primarily affected by PPS. Conclusion: Post-polio syndrome is a disorder characterized by new neuromuscular deficits that present years after the resolution of polio infection. However, far beyond the physical pain, the psychosocial impact is staggering. Therefore, in addition to surgical intervention and physical therapy, attention should be paid to the psychological follow-up of this patient, who is most often elderly.

Pseudomeningoceles are rare complications of laminectomy surgery. Such clinical condition results from an inadvertent surgical dural rupture. We describe in the present study the report of a patient who developed iatrogenic pseudomeningocele in the lumbar region after performing a left laminectomy in L5 topography. After the neurological assessment of the patient, bilateral hypoaesthesia was observed, in addition to a floating bulging in the lumbar region that was accentuated during the valsalva maneuver, with the hypothesis of a pseudomeningocele.

Video 1. A 60-year-old man presenting dystonic movements during writing (writer's cramp), with a significant clinical improvement after the treatment with baclofen.

Extramedullary plasmacytoma is a rare disease, characterized histopathologically by infiltration of plasma cells of different maturities and producing monoclonal immunoglobulin outside the bone marrow. J.R.G., 52 years old, male, sought medical assistance due to amaurosis and blocked eye movements. We performed Magnetic Nuclear Resonance of the skull that showed discrete intermediate signal tissue, next to the optic nerve canal and homolateral superior orbital fissure, with slight extension to the lower orbital fissure, associated with thickening of the corresponding meninges, involving the proximal portion of the optic nerve, measuring 1.3 x 1.1 x 2.5 cm. Non-specific aspect, but suggestive of lymphoproliferative lesion. Right and extraorbital tumor excision was performed, in which it was not possible to completely resect the tumor. The anatomopathological examination of the piece showed a neoplasm of plasma cells (plasmacytoma). The diagnosis is made from the exclusion of Multiple Myeloma. The treatments of choice are radiotherapy, due to the high radiosensitivity in 80–100% of cases, and surgery for localized lesions.