hospital referência em infectologia na Amazônia. METODOLOGIA: Foi realizado um estudo transversal e retrospectivo, com informações obtidas por revisão dos prontuários dos doentes, internados de 1° de janeiro de 2000 a 31 de julho de 2011. Foram considerados todos os registros de 289 pacientes internados com hipótese diagnóstica de malária e examinados os prontuários correspondentes, sendo descartados os prontuários ilegíveis e os indisponíveis. RESULTADOS: Após serem descartados os casos sem confirmação diagnóstica, a casuística resultou em 188 prontuários. Predominaram indivíduos do sexo masculino (61,2%; 115/188) e da faixa etária de 30 a 50 anos (33%; 62/188); houve mais internações nos meses de agosto (13,5%; 24/188) e outubro (12,4%; 22/188). O Plasmodium vivax foi o mais incidente, com 56,9% (107/188) dos casos, havendo 41,5% (78/188) casos de P. falciparum. As principais manifestações clínicas encontradas foram febre (97,3%; 183/188), cefaleia (58%; 109/188) e calafrios (54,8%; 103/188). A manifestação clínica mais frequente relacionada à malária grave foi icterícia (38,3%; 72/188). Quanto ao perfil laboratorial, 86,2% (162/188) apresentaram hematimetria baixa; 93,6% (176/188) hematócrito baixo; 73,9% (139/188) evidenciaram plaquetopenia. CONCLUSÃO: Na população estudada, a malária foi mais incidente nos meses de agosto e outubro, em homens e na faixa etária de plena atividade laboral. As principais manifestações clínicas e laboratoriais foram aquelas típicas da doença e a icterícia se destacou como principal manifestação da malária grave.

Spontaneous intracranial hypotension (SIH) is a syndrome that was unknown until the advent of magnetic resonance imaging (MRI). It is a cause of orthostatic headache, which remains underdiagnosed and, rarely, can result in several complications including dural venous sinus thrombosis, subdural hematoma and subarachnoid hemorrhage. Some of these complications are potentially life-threatening and should be recognized promptly, mainly by imaging studies. We reviewed the MRI of nine patients with SIH and describe the complications observed in three of these patients. Two of them had subdural hematoma and one had a dural venous sinus thrombosis detected by computed tomography and MRI. We concluded that MRI findings are of great importance in the diagnosis of SIH and its complications, which often influence the clinical-surgical treatment of the patient.

Sensory neuronopathy (SN) is characterized by primary dorsal root ganglia damage and typically manifests as sensory ataxia with multifocal non-length-dependent sensory deficits 1,2 . First described in 1948 by Dr. Derek Denny-Brown 3 , the full phenotypic spectrum and the identification of all SN-related disorders are still pursued 4 . In a way rarely seen ABSTRACT Sensory neuronopathies (SN) are a group of peripheral nerve disorders characterized by multifocal non-length-dependent sensory deficits and sensory ataxia. Its recognition is essential not only for proper management but also to guide the etiological investigation. The uncommon SN clinical picture and its rarity set the conditions for the misdiagnosis and the diagnostic delay, especially in non-paraneoplastic SN. Therefore, our objectives were to characterize the diagnostic odyssey for non-paraneoplastic SN patients, as well as to identify possible associated factors. Methods: We consecutively enrolled 48 non-paraneoplastic SN patients followed in a tertiary neuromuscular clinic at the University of Campinas (Brazil). All patients were instructed to retrieve their previous medical records, and we collected the data regarding demographics, disease onset, previous incorrect diagnoses made and the recommended treatments. Results: There were 34 women, with a mean age at the diagnosis of 45.9 ± 12.2 years, and 28/48 (58%) of the patients were idiopathic. Negative sensory symptoms were the heralding symptoms in 25/48 (52%); these were asymmetric in 36/48 (75%) and followed a chronic course in 35/48 (73%). On average, it took 5.4 ± 5.3 years for SN to be diagnosed; patients had an average of 3.4 ± 1.5 incorrect diagnoses. A disease onset before the age of 40 was associated to shorter diagnosis delay (3.7 ± 3.4 vs. 7.8 ± 6.7 years, p = 0.01). Conclusions: These results suggest that diagnostic delay and misdiagnosis are frequent in non-paraneoplastic SN patients. As in other rare conditions, increased awareness in all the healthcare system levels is paramount to ensure accurate diagnosis and to improve care of these patients.

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