Today, traumatic brain injuries continue to be studied, increasingly investigating the pathophysiological mechanisms that contribute to the clinical presentation, severity, and possible sequelae, but despite this, the prognosis of these patients is sometimes poor. Mitochondrial dysfunction comprises a series of reactions that contribute to the inflammatory process in these patients that have an impact on the prognosis, since it is one of the pathophysiological mechanisms involved in secondary lesions after a traumatic brain injury; and therefore has opened a field of study in the search of possible biomolecular markers that allow us to establish a prognosis and prediction of mortality.

REsUMEnLas metástasis del cáncer de próstata en las meninges intracraneales son raras y con frecuencia son confundidas con meningiomas, hematomas epidurales o subdurales crónicos. Usualmente se presentan en pacientes con diagnóstico oncológico conocido en estadios avanzados de la enfermedad y solo en algunos raros casos sus manifestaciones han precedido a la detección del tumor primario. La presentación clínica es inespecífica, sin embargo, por la afinidad de estos tumores por la base del cráneo, constituye un diagnós-tico diferencial del compromiso de pares craneales en varones mayores de 70 años.El tratamiento de estas lesiones no ha sido estandarizado y dentro de las opciones terapéuticas están la resección quirúrgica, quimioterapia, radioterapia o la combinación de estas medidas y aún así la supervivencia es corta.Se presenta el caso de un varón de 77 años cuya manifestación inicial del cáncer de próstata fue la sintomatología producida por una lesión metastásica en la duramadre, confirmada por histopatología. Se revisan los aspectos epidemiológicos, clínicos y de imagen más sobresalientes de las metástasis meníngeas del cáncer de próstata.Palabras clave. Cáncer de próstata. Metástasis durales. Metástasis intracraneales. Hematoma subdural. Metás-tasis leptomeníngeas. aBstRactMetastases of prostate cancer to intracranial meninges are rare and often confused with meningiomas or chronic subdural hematomas. These usually occur in patients with a known cancer diagnosis in advanced stages of the disease, and only in some rare cases do its manifestations precede the detection of the primary tumour. The clinical presentation is unspecific. However, due to the affinity of this tumour for the base of the skull, it must be included in the differential diagnosis of men over 70 years of age with cranial nerve palsy.The treatment of these lesions has not been standardized. Within the therapeutic options we find surgical resection, chemotherapy, radiotherapy or a combination of these measures, and yet survival is poor.We present the case of a 77 year old male patient whose initial symptoms of prostate cancer were caused by a metastatic lesion to the dura, confirmed by histopathology. We also review the epidemiological, clinical and imaging highlights of this condition.

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Severe subdural empyema (SDE) involving both the brain and spinal cord can be a life-threatening condition if not treated properly. We describe a malnourished patient with extensive spinal and intracranial SDE, whose poor prognosis prompted palliative care consultation. Surgical options were not possible. However, following maximal medical therapy, the patient's condition resolved completely in 1 year. This case highlights the important relationship between neurocritical care medical management and infection when surgical options are not possible.