Introduction: Transcranial Doppler (DTC) is useful in the evaluation of vasospasm after subarachnoid hemorrhage (SAH). Thus, it is important to know the accuracy and impact of this tool in the management of patients. Objective: Analyze the use of DTC in the detection of vasospasm after subarachnoid hemorrhage and its clinical relevance. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health, Bahia, Brazil. Methods: The evaluated studies were obtained in PubMed, published since 2010. The studies did not correspond with the purpose of this review were excluded. Results: 26 of the 515 articles found, were select. Clinical studies that sought to demonstrate the accuracy of TCD in the detection of vasospasm and prediction of Delayed Cerebral Ischemia show high sensitivity and negative predictive value.There are studies that measure the accuracy of DTC in detecting angiographic vasospasm with high specificity. New parameters are emerging for the detection of vasospasm, even early. However, there are studies that demonstrate that the use of TCD does not favor the clinical outcomes of patients after SAH. Conclusion: TCD has moderate-high accuracy and can help in the detection and management of patients with vasospasm. Nonetheless, there are studies that refute the relevance of TCD in HSA. Furthermore, there is a lack of concrete evidence, with larger studies, for the widespread use of this tool with greater reliability and precision.

Background and objective: Multiple Sclerosis (MS) is a neurodegenerative, inflammatory and demyelinating disease of the central nervous system. The mechanisms that cause MS are still unknown. However, many variables appear as possible risk factors for the development of this disease. Therefore, this review aims to analyze the prevalence of MS cases in adult patients with a history of previous Epstein-Barr (EBV) or Cytomegalovirus (CMV) infection. Design and settings: This study is a literature review, produced in Bahiana School of Medicine and Public Health, Salvador, Bahia, Brazil. Methods: The studies evaluated were observational studies, published from 2016 to 2021, obtained in PubMed, with MeSH terms, published. The studies that did not correspond with the purpose of this review were excluded. Results: The search resulted in 254 articles, of which 60 were selected. In cohort studies, EBV was indicated as a relevant risk factor and CMV was identified as a protective factor. Besides, cross-sectional studies differ in relation to CMV being considered a risk or protection factor, while EBV was pointed out as a risk factor again. However, case-control studies show that there is no association between Epstein-Barr or Cytomegalovirus with the risk of developing Multiple Sclerosis. Conclusion: The evidence is still very uncertain, mainly due to the quality of the studies produced so far. Further studies of better methodological quality are needed to prove whether there is a causal association between these factors.

Background: Though pharmacotherapy of Attention Deficit Hyperactivity Disorder (ADHD) is widespread, some patients suffer with side effects or do not improve with it. Objectives: Evaluate clinical outcomes of non-pharmacological therapy on ADHD. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health. Methods: Articles published between 2011 and 2021 were taken from PubMed, using the following search: (“Non-pharmacological treatment” OR “Non- pharmacological therapy” OR “Non-pharmacological intervention” OR “Non-drug treatment” OR “Non-drug therapy” OR “Adjuvant treatment” OR “Adjuvant therapy”) AND (“ADHD” OR “Attention Deficit-Hyperactivity Disorder”). Studies that did not match this review’s objectives were excluded. Results: 20 of the 57 articles found, were selected. Reviews that approach treatment in general indicate non-pharmacological therapy specially when there are obstacles to use of drugs, but highlight the lack of studies with methodological quality in this field. Clinical studies indicate reduction of symptoms through neurofeedback, transcranial magnetic stimulation, and aerobic exercises. One of the interventions with the most articles was nutritional supplementation, though most of them did not find significant improvement. Conclusions: Non-pharmacological treatment of ADHD is a relevant alternative, especially when there is no response to medication, but studies with better methodological quality are necessary.

Background: Aneurysms have their wall more susceptible to rupture. It is postulated whether the presence of atherosclerotic plaque can influence this, protecting or not. Objective: This review aims to investigate atherosclerosis (AT) as a potential risk factor for rupture of intracranial aneurysms. Design and Setting: this is a literature review, produced in Bahiana School of Medicine and Public Health. Methods: The evaluated studies were obtained in published between 2011 and 2021, using the MeSH terms with following search: ((“atherosclerosis” OR “atherogenesis” OR “atheroscleroses” OR “Vascular Disease”)) AND ((“intracranial aneurysm” OR “brain aneurysm” OR “brain aneurysms” OR “cerebral aneurysm” OR “cerebral aneurysms”)) AND ((“ruptured” OR “rupture” OR “subarachnoid hemorrhage”)). Those that did not correspond the purpose of this review were excluded. Results: 13 of the 103 articles found, were selected. In 03 retrospective cohorts, AT was not a risk factor associated with aneurysm rupture, but a protective factor. In the control case, AT did not obtain statistical significance, but hypercholesterolemia was considered a protective factor. In the postmortem, atheromatous plaque was found only in a one patient who had subarachnoid hemorrhage. The other studies were inconclusive on the subject. Conclusions: Atherosclerosis cannot yet be said as a risk factor for aneurysm rupture due to literary insufficiency. In this way, new research is needed to ensure the evidence.