Objetivo: Realizar uma revisão integrativa acerca das manifestações clínicas e impacto da síndrome da COVID longa em adultos.  Metodologia: Trata-se de um estudo com abordagem qualitativa, revisão integrativa, cuja coleta de dados do artigo foi realizada pelo software “Publish ou Perish”, com busca com título e palavras-chave “long COVID” e “post COVID” e selecionados artigos que possuem H-index, uma métrica de citação. Resultados e Discussão: Foram pesquisados 3999 artigos, sendo 567 com H-index e 29 selecionados para artigo. Agrupados por temáticas: epidemiologia da COVID longa: grupos mais afetados; fatores de risco ou preditores; manifestações clínicas; progressão dos sintomas; relação entre a gravidade do quadro agudo e a COVID longa; situação especifica após alta hospitalar e impacto socioeconômico. O estudo evidenciou a maior prevalência em pessoas do sexo feminino, maior faixa etária, com uma relevância de dados para persistência dos sintomas, com muitos ou sintomas específicos no início do quadro como fator de risco, cuja manifestações clínicas mais frequentes foram fadiga, dispneia e quadro neuropsicológico, com progressão variável e impacto significativo na saúde e vida. Conclusão: Devido a dimensão de pacientes acometidos e da proporção da síndrome da COVID longa apresentado nos estudos, é necessário conseguir identificar os aspectos relacionados a COVID longa e o impacto na qualidade de vida e na subsistência dos indivíduos a fim de incentivar a produção científica acerca de temas ainda não bem esclarecidos e fornecimento de atualizações aos profissionais de saúde.

Context: The Artery of Percheron (AOP) is an uncommon anatomic vascular variation derivated from posterior cerebral artery segment P1, wich branchs to irrigate bilaterally the thalamus in it is paramedian portion. Amidst vascular cerebral events of the ischemic type, thalamic infarction occour in 11% of the cases. The typical clinical presentation is constituted by the triad: cogniyivebehavior comitente, oculomotors and consience disturbs. Case report: J.F.M.L, 51 years old, male, was found unconscious in his residence by SAMU and then interned in Stroke Room of HGP in 02/06/2020 with a lowered level of consciousness (Glasgow 8). The tests demonstrated a bilateral thalamic infarct due to Artery of Percheron Ischemia. In 02/09/2020 it evolved into a Glasgow 9 being extubated. The CT after 3 days demonstrated absence of bleeding and prophylatically initiated simvastatin, clexane, physiotherapy and phonoaudiology. In 02/15/2020, during physical exam, the pacient was lucid, presented behavior alterations, had left cervical dystonia and ataxia. The patient progressed well and was discharged the next day. Conclusions: The AOP, when occluded, results in bilateral paramedian thalamic and the rostral midbrain infarctions wich may cause diagnosis issues, mainly because of the vast specter of diferential diagnosis. In the presence of triad signals characteritic of bilateral thalamic infarction in CT, it must suspect the manifestation of such entity.

Context: Tolosa-Hunt Syndrome (STH) is a rare condition with unknown etiology, it affects both genders equally. It is manifested by inflammation of the cavernous sinus and involvement of some cranial nerves pairs. Case report: MSR, 39 years, male, diver in the mining zone, history of recurrent otitis with acute pain and gradual hearing loss that progressed. He was admitted to the General Hospital of Palmas with symptoms of retrorbital headache. After physical exams it was found an ophthalmoplegia with right amaurosis and ipsilateral pain. The neurological examination showed a right eye with loss of photomotor reflex and presence of consensual reflex and eyelid ptosis. After 38 days in hospital, a probable septic thrombosis of the cavernous sinus was found, antibiotic and corticosteroids therapy was initiated. The patient also reports significant improvement in headache and partially in vision, he is currently hospitalized with clinical care and antibiotic therapy, awaiting results of the image examination report. Conclusions: Painful ophthalmoplegia in most cases is not diagnosed as STH. The differential diagnosis for this pathology is most often through brain magnetic ressonance and the ICHD-3 beta diagnostic criteria, STH should be suspected, but it is still necessary to close the diagnosis by exclusion, due to the lack of a specific diagnosis.

Context: Elsberg Syndrome (ES) is a rare syndrome associated with acute or subacute infections, often accompanied by myelitis confined to the lower spinal cord, in addition to paresthesia, weakness in the lower limbs, urinary retention, constipation, among others. It is a self-limiting disease, manifested through primary HSV type 2 infection, especially in immunocompetent patients. Case report: Male patient J.F.C., 58 years old, reports a sudden paresthesia in the lower limbs without other associated clinical conditions for approximately 2 months that progressed to paresis, cramps and loss of sphincter control. Admitted to the General Hospital of Palmas, Tocantins on 02/18/2020 with suspicion of Peripheral Polyneuropathy that was discarded after electroneuromyography. Imaging exams without relevant findings. After a week of hospitalization, multiple lesions appeared in the region of the lower third of the dorsum and buttocks, compatible with lesions by HSV (herpes simplex virus) and the diagnosis of ES was concluded. At the moment, he was undergoing treatment with acyclovir and awaiting the evolution of the condition. Conclusion: ES is an often unrecognized cause of lumbosacral radiculitis, which is why it is important to establish as a diagnosis differential. The analysis of CSF, PCR and MRI confirm the diagnosis in cases of HSV-2 lumbosacral radiculomyelitis. CSF usually reveals a lymphocytic pleocytosis and a slight elevation of proteins.