In December 2019, in Wuhan, China, the first cases of infection with SARS-CoV 2 responsible for COVID-19 disease were identified. SARS-CoV 2 was declared a pandemic on March 11, 2020, and since then has attracted the medical world's attention. The threat to humans' health that this emerging pandemic could leave raises awareness on the importance of understanding the mechanisms that underlie the developing conditions. The epidemiology, clinical picture, and pathogenesis of COVID-19 show that this virus presents new strategies to overcome the past defensive medicine. While all the current data has focused on the pulmonary and cardiovascular manifestations, little has been written about the neurological implications of the disease. This review updates new clinical aspects that SARS-CoV 2 expresses in humans by focusing primarily on neurological manifestations. The damage to the nervous system became more apparent - anosmia, ageusia, polyneuritis, meningitis, meningoencephalitis, stroke, acute necrotizing encephalopathy. Oxygen therapy is vital for those in critical health situations. Finally, prevention is the most important element in breaking the epidemiological chain.

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Context. Craniopharyngiomas (CPH) are benign tumors, rarely encountered in children, representing 5-6% of all intracranial tumors. Objective. This study aimed to analyze the surgical management and quality of life in a series of CPH pediatric cases. Design. This was a multicenter study performed over a 25-year period (1994-2019) in Bucharest. Subjects and Methods. 152 children (0-17 years old) were treated for CPH. Preoperative manifestations were intracranial hypertension, endocrine dysfunction, visual impairment, ataxia, intellectual performance decrease. Results. Considering all surgical approaches used, we advocate for pterional approach to best fit in CPH. We achieved gross-total removal (GTR) in 83 cases (54.4%), near-total resection (NTR) in 13 cases (9%), partial resection (PTR) in 51 cases (33.3%). 5 cases were biopsies (3.2%). Gamma Knife Surgery was performed in 10 cases (6.5%), all recurrences. At 6 months GOS revealed: Good Recovery 70 cases (46.2%), Moderate Disability 62 cases (40.7%), Severe Disability 13 (8.5%), Vegetative State 2 cases (1.3%), Deceased 5 cases (3.2%). Complications were: diabetes insipidus (89.3%); hypopituitarism (66.4%); hypothalamic damage (17.7%); visual deterioration (18.4%). Conclusions. Surgery remains the main option, but GTR complications prove the necessity for a multidisciplinary approach. Outcome predicting factors are: age, tumor size, hydrocephalus degree, hypothalamic dysfunction.

AIM:To analyze the demographic characteristics and surgical outcomes of the largest series of patients with pediatric aneurysms reported in Romania, in consideration of the primary factors that lead to good long-term outcomes. Given that all cases involved ruptured aneurysms, we also investigated the ability of microsurgical clipping to prevent massive hemorrhage andaggravation of neurological deficits. MATERIAL and METHODS:This multicenter retrospective study included 47 pediatric patients (<16 years old) who underwent operation over the 20-year period between January 1999 and January 2019. We analyzed medical records and imaging findings in each patient. Treatment consisted of open microsurgical dissection (clipping) and endovascular embolization (coiling). RESULTS:Mean patient age was 14.3 years, ranging from 5 months to 16 years, with 28 boys (59.5%) and 19 girls (40.4%). In our series, pediatric aneurysms represented 6.1% of all intracranial aneurysms (771 cases). Clinical features were dominated by headache (45 cases, 95.7%), neck stiffness (43 cases, 91.4%) and vomiting (42 cases, 89.3%). The most frequently involved locations were the anterior communicating artery (17 cases, 36.1%), middle cerebral artery (12 cases, 25.5%), and internal carotid artery bifurcation (9 cases, 19.1%). Glasgow Outcome Scale scores at 6 months indicated good recovery in 36 patients (76.5%), moderate disability in ninepatients (19.1%), severe disability in one patient (2.1%), and (preoperative) death in one patient (2.1%). CONCLUSION:Intracranial aneurysms in children are very rare. Early diagnosis based on brain imaging and microsurgical treatment is essential for attaining excellent results.Primary factors such as preoperative status, child profile, aneurysm size, treatment choice, and timing of the operation influence both short and long-term outcomes.

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