La cefalea es uno de los motivos más comunes de presentación en el servicio de urgencias, la mayoría son benignas, pero es imperativo comprender y discernir las causas que amenazan la vida cuando se presentan. El dolor de cabeza causado por una hemorragia subaracnoidea por un aneurisma roto es uno de los más mortales, con una letalidad significativa. El objetivo de este estudio es actualizar los referentes teóricos de la hemorragia subaracnoidea, métodos de diagnóstico y del manejo terapéutico. Se realizó una búsqueda sistemática de investigaciones recientes en bases de datos de Elsevier, Pubmed y Scopus de articulos publicados entre el 2013 al 2020, de idioma inglés y español. La causa más frecuente de la HSA es el aneurisma cerebral y abordaje quirúrgico se fundamenta en evitar la aparición de dos de sus principales complicaciones neurológicas como el resangrado y el vasoespasmo. En los pacientes no tratados quirúrgicamente es frecuente que recidive la hemorragia. El estudio de elección es la Resonancia magnética y la angiografía, siendo el nimodipino la terapia recomendada para la prevención de la isquemia cerebral.

Summary: The frequency and importance of posterior fossa evaluation has increased signicantly in the last 20 years due to advances in neuroimaging. Today, conventional and advanced neuroimaging techniques allow a detailed assessment of the complex anatomical structures within the posterior fossa. A wide spectrum of congenital anomalies (anomalies due to an alteration of the primary developmental program caused by a genetic defect) and due to the breakdown of a structure that had a potential for normal development has been demonstrated. Knowledge of the spectrum of congenital anomalies of the posterior fossa and its well-dened diagnostic criteria is essential for optimal therapy, an accurate prognosis, and correct genetic counseling. Objective: Analyze the importance of the precise diagnosis of congenital anomalies of the posterior fossa, emphasizing Dandy Walker syndrome, through a clinical case. Design: Prospective, observational in a single center. Methodology: This is a systematic review, Dandy Walker syndrome, detailing its clinical characteristics and short-term complications. The information and images obtained belong to the medical personnel in charge of the case, whose reinforcements are provided by the Excel, Word and JPG statistical package.

Acute cerebrovascular attack (CVA) is the second cause of death in the world and generates high costs in its treatment and recovery, as well as a great socioeconomic impact, since it is the main cause of longterm disability. Although simple brain computed tomography (CT) is still the image recommended by international guidelines for the initial evaluation and decision-making on the management of patients with suspected stroke, in recent years there have been extraordinary advances in timely diagnosis and early stroke with new tools that range from the standardization of cerebral computed tomography angiography as one of the main studies in the initial approach to the use of brain tomography and magnetic resonance imaging (MRI) perfusion techniques, which make it possible to establish the nucleus of the infarct and the potentially salvageable surrounding area, so it is possible to offer therapies that provide the patient with functionality and quality of life in the medium and long term. Taking into account the above, we are encouraged to present this case, of an elderly patient who presented this pathology, where the intestinal ileum was also added. Objective: To describe cerebral infarction in a nonagenarian affected patient. Design: Prospective, observational in a single center. Methodology: This is a systematic review of cerebral infarction in a nonagenarian patient, emphasizing its clinical characteristics and short-term complications. The information and images obtained belong to the medical personnel in charge of the case, whose reinforcements rest on the statistical package Excel, Word and JPG.