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Background: The infection caused by SARS-CoV-2 is associated with several neurological manifestations. Among these, acute disseminated encephalomyelitis (ADEM), an immune-mediated disease, has a reasonable incidence. In this context, the absence of direct viral infection of the CNS and late presentation of the condition corroborate to the hypothesis of an immune relationship. Objectives: Describe the relation between acute disseminated encephalomyelitis and COVID-19 infection. Design and setting: Literature review, held at the University Center of João Pessoa, located in the city of João Pessoa, Paraíba, Brazil. Methods: Through the PubMed database, using descriptors as follows: “acute disseminated encephalomyelitis” AND “COVID-19”, associated with time filter of the years 2020-2021. Results: The pathogenesis of ADEM in COVID-19 occurs through several mechanisms. One is a cross reaction between immune cells and nerve cells, which causes damage by activating the immune response and releasing protease enzymes. Another perspective is that the state of hyperinflammation activates like glial cells. In addition, an infection can trigger the production of autoantibodies against glial components, generating demyelinating lesions. In a series of cases that included 43 patients, nine had manifestations of ADEM, with a variety of clinical and radiological forms. Of these nine, on neuroimaging, all had multifocal, supratentorial white matter, four had hemorrhagic changes and two had myelitis. Conclusions: The coexistence between ADEM and COVID-19, although well established in some cases, still shows the need for studies that better clarify the relation between viral infection and brain lesions present in these clinical conditions.

Introduction: The use of corticosteroids, especially dexamethasone, for the treatment of Chronic Subdural Hematoma (CSDH), is a secular conduct protocol. However, recent studies contradict this recommendation in some points. Objectives: To score the use of dexamethasone in patients with Chronic Subdural Hematoma. Methodology: Literature review, based on PubMed database using the descriptors “Desamethasone”, “Chronic Subdural Hematoma” and “Treatment”, using a time filter from the years 2020-2021. Results: In a study with 443 neurosurgeons, 26.2% of respondents estimate that corticosteroids are highly effective in CSDH, with 46.2% using dexamethasone as monotherapy in conservative treatment. According to a randomized study conducted by The New England Journal, 375 people diagnosed with CSDH were treated with dexamethasone while 373 received the placebo, where 94% had undergone surgical treatment previously. At the end of the study, only 680 candidate patients continued to be analyzed, of which a favorable outcome was seen in 286 of 341 (83.9%) in the dexamethasone group and in 306 of 339 patients (90.30) in the placebo group, where there is a difference of 6.4 percentage points in favor of the placebo. In addition, in the same study, more adverse effects occurred in the dexamethasone group, however, 1.7% of the patients in this group needed surgery for hematoma recurrence compared to 7.1% in the group that used the placebo. Conclusion: It is possible to say that treatment with dexamethasone caused more adverse effects and resulted in less favorable outcomes, however, the recurrence for the number of surgeries was lower.

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