Es llevado a un servicio de urgencia tras presentar caída a nivel mientras deambulaba, resultando con contusión de hemicuerpo izquierdo y dolor de parrilla costal ipsilateral, incrementado al esfuerzo físico e inspiración. Niega contusión craneana o pérdida de conciencia. En Urgencia se solicita TAC de tórax que muestra múltiples fracturas costales izquierdas (7º a 12º costilla) sin signos de contusión pulmonar. TAC de cerebro descarta complicación aguda. Exámenes de laboratorio sólo revelan leve anemia normocítica, normocrómica y glicemia 126 mg/dl. ECG con ritmo sinusal y alteraciones inespecíficas de la repolarización.

Dementia and mainly Alzheimer´s disease is a very serious and frequent clinical problem. So far, the pharmacological treatment with approved drugs has been essentially symptomatic. Although the aetiology of AD is not yet fully understood, new therapy approaches are primarily based on the amyloid hypothesis. Unfortunately the new drugs with amyloid target have had difficulties to show consistence in efficacy and safety. On the other hand, neurotrophic factors such as NGF and BDNF are small, versatile proteins that maintain survival and function to specific neuronal populations, for instance cholinergic neurons, on which they have a trophic and protective effect. Cerebrolysin is a peptidergic drug, approved for Alzheimer´s disease in some countries, containing biologically active peptides that exerts nerve growth factor like activity and it has interesting data about pleiotropics properties of the compound. Some clinical trials with cerebrolysin have demonstrated cognitive and functional benefits when comparing with placebo. In a complex therapeutic scene appears necessary to explore with more clinical trials the neurotrophic way.