COVID-19 patients may exhibit neuropsychiatric and/or neurological symptoms. We found that anxiety and cognitive impairment are manifested by 28-56% of SARS-CoV-2-infected individuals with mild or no respiratory symptoms and are associated with altered cerebral cortical thickness. Using an independent cohort, we found histopathological signs of brain damage in 19% of individuals who died of COVID-19. All of the affected brain tissues exhibited foci of SARS-CoV-2 infection, particularly in astrocytes. Infection of neural stem cell-derived astrocytes changed energy metabolism, altered key proteins and metabolites used to fuel neurons and for biogenesis of neurotransmitters, and elicited a secretory phenotype that reduces neuronal viability. Our data support the model where SARS-CoV-2 reaches the brain, infects astrocytes and triggers neuropathological changes that contribute to the structural and functional alterations in the brain of COVID-19 patients.

COVID-19 patients may exhibit neuropsychiatric and neurological symptoms. We found that anxiety and cognitive impairment are manifested by 28-56% of SARS-CoV-2-infected individuals with mild respiratory symptoms and are associated with altered cerebral cortical thickness. Using an independent cohort, we found histopathological signs of brain damage in 25% of individuals who died of COVID-19. All of the affected brain tissues exhibited foci of SARS-CoV-2 infection and replication, particularly in astrocytes. Infection of neural stem cell-derived astrocytes changed energy metabolism, altered key proteins and metabolites used to fuel neurons and for biogenesis of neurotransmitters, and elicited a secretory phenotype that reduces neuronal viability. Our data support the model where SARS-CoV-2 reaches the brain, infects astrocytes and triggers neuropathological changes that contribute to the structural and functional alterations in the brain of COVID-19 patients.

Gerstmann Syndrome (GS) is a rare neurological condition described as a group of cognitive changes corresponding to a tetrad of symptoms comprising agraphia, acalculia, right-left disorientation and finger agnosia. It is known that some specific brain lesions may lead to such findings, particularly when there is impairment of the angular gyrus and adjacent structures. In addition, the possibility of disconnection syndrome should be considered in some cases. The purpose of this article is to report a case of a young, cardiac patient, non-adherent to treatment, who presented with a stroke in which transient clinical symptoms were compatible with the tetrad of GS. The case report is followed by a discussion and brief review of the relevant literature.

Spinal epidural hematoma can occur spontaneously or as a secondary condition and it represents less than 1% of space-occupying lesions within the spinal canal. The incidence of spontaneous epidural bleeding is estimated to be 0.1 cases per 100,000 populations per year. Typical clinical manifestations include acute onset of back pain, sometimes associated with radicular paresthesia and signs of spinal cord compression in some cases. The clinical presentation with hemiparesis is rare, and it may hinder the diagnosis, especially in emergency situations. The purpose of this article is to present a clinical case of acute epidural hematoma with atypical clinical presentation, followed by literature review of spinal epidural hematoma.

Disconnection syndromes are classified as higher function deficits that result from lesions to white matter or association cortices, the latter acting as relay stations between primary motor, sensory, and limbic areas. In 1965, Norman Geschwind brought disconnection to the fore after publishing a paper entitled "Disconnexion syndromes in animals and man." In the last decades, a large number of studies concerning this topic have been published in order to elucidate new perspectives of localizationist view of brain functioning. In view of those considerations, it is noteworthy to mention that the understanding of connection pathways involving frontal lobe is one of the most challenging fields of research in neuroscience. The better comprehension of those concepts is an important mark for the multidisciplinarity of neurology, neurosurgery, and psychiatry. The purpose of this chapter is to expose relevant data of recent literature embracing the association between disconnection syndromes and frontal lobe dysfunction.