The impact of fear in the post covid era

Feeling fear is involuntary, as it is often unconscious. However, there are other faces of fear that we can recognize and that are familiar to us. We go from real fears to unreal fears, from present fears to projective fears that are reinforced and mutate into other more complex situations that further reinforce our fear. The more we reinforce these thoughts the stronger our fear becomes. So, what is feeding our fear? How do we react to fear? Is it the desire to dodge the blow, to strike back, to attack it? Fear is a very powerful mechanism that should only be activated in dangerous situations. If we use fear for educational purposes we will project very deep blockages in the new generations. However, when we recognize and accompany the thoughts and impulses generated by fear, they become silent. Once silenced, they are no longer activated unconsciously. Therefore, if we look at what is happening, consciously, "without judgement" it will facilitate our journey towards our true SELF. The EmocionaTFamilia program invites us to accompany our path "lightly and at the right time". Change is simple, the lesson is the opposite of what we have learned.

Effectiveness of atorvastatin in acute atherothrombotic cerebral infarction

Introduction: Cerebrovascular Diseases (CVD) constitute one of the most important health problems on a global scale and in Cuba they occupy the third cause of death and the first cause of disability. Objective: To evaluate the use of atorvastatin in the acute phase of atherothrombotic cerebral infarction. Method: A prospective longitudinal study was carried out in patients who attended the on-call department of the Julio Trigo López Hospital and were diagnosed with acute atherothrombotic cerebral infarction, who were randomly administered with prior informed consent: 0, 20 mg or 40 mg of atorvastatin , they underwent CAT (Computerized Axial Tomography) of the skull, which was repeated on the third day and at 30 days, the value of PCR (C Reactive Protein) was determined in on-call body, on the fifth day and at 30 days, they were clinically evaluated according to the NIHSS scale (National Institute of Health Stroke Scale) in on-call body , daily during their admission and 30 days later. Results: The size of the infarct area decreased by 19.4% with 40 mg of atorvastatin as did the CRP value which was reduced by 16 mg/Ll. The clinical assessment (NIHSS scale) was reduced according to the dose of atorvastatin by slightly more than 8 points. Conclusions: The decrease in infarct area was directly proportional to the dose of atorvastatin used, just as the CRP values were lower and the favorable clinical evolution was associated with the use of this.

A rare case: Penetrating craneoencefalic trauma by knife

Background: Cranioencephalic penetrating trauma (CPT) is caused by a sharp or short- pointed object that passes through the bone, dura mater, brain and other structures. Its incidence is unknown and few cases are described; penetrating injuries represent 0.4%, therefore there is no protocolized management. Case report: A 24-year-old male patient suffered penetrating trauma at left parietal region with a "knife"; he was sutured and sent home with analgesics. Five days after the trauma, he was admitted for headache, disorientation and decreased visual acuity. X-ray (XR) of Cranium evidencing a foreign body, therefore it is sent to a reference hospital. Evolution: The diagnosis is confirmed by a computerized tomography (CT) scan of the skull with 3-dimensional reconstruction (3D) plus CT angiography (angio CT), which shows "knife" in the left parietal region without vascular compromise. Neurosurgeons perform removal of the foreign body plus a dura mater plasty. Patient stay 12 days hospitalized with a favorable evolution and improvement of neurological symptomatology. Conclusion: CPT due to a knife is an emergency and there is no protocolized management. The removal of the foreign body must be done in a hospital for the risk of lesions of large vessels.

Mirror neuron: a beautiful unnecessary concept

Mirror neurons theory, which had been put forward in the eighties based on the results of cognitive research experiments on the macaque monkeys, has prima facie been further validated by the extensive cognitive neurosciences investigations of primates and humans, over the past three decades. The concept was initially prompted by the fact that the brain activity patterns of the subjects were nearly similar, whether the activity was performed or observed by them. And presently, learning of various natures and empathy, and perhaps some aspects of survival, are ascribed to the operations of this class of neurons. Obviously the added complexity on the already complex field of neurosciences cannot be underestimated; and of course there are opponents of the theory, and some profound questions have been raised. Present work, though also in opposition, is based on completely different ground: the fact that the ingenious and grand efforts of the proponents of the theory can be explicated in the realm of the established neural structure of the brain and its computational operations. This possibility is based on the recent discovery of the tactile nature of the vision sensation. Ironically all the results, which form the basis of the mirror neuron concept, also serve to provide the conceptual proof of the new vision theory, which preempts any need for the introduction of the new class of neurons. The vision theory, partially validated through the efforts of the development of the tactile vision substitution systems (TVSS) and ironically also by some to the point mirror neuron experimental works, are sufficient to explain the processes behind empathy, learning and perhaps other mental phenomena; and as such, the need for presumption of additional class of neurons is dispelled. The mental phenomena, which rendered the claim of the mirror neurons, are simply the consequence of subjects beings variably touched by the state of the living environment, through the coherent tactile operation of all senses (four already known as having tactile nature); eyes having the most prominent role: It is the brain’s response (the computations outputs) as motor cortex activity,-- subsequent to the discernment of the streaming massive tactile input data, to appropriately coordinate the observer’s perceived (tactile) engagement, conditioned by the her mental intentional stance sourced in the brain’s protocols (acquired neural patterns)--which is misinterpreted as the evidence for the conceptualization of the mirror neuron.

Unilateral drainage of bilateral chronic subdural hematoma

Bilateral chronic subdural hematoma (bCSDH) is a condition frequently encountered in neurosurgical practice, and it is usually the result of head trauma. Despite its frequency, no consensus currently exists regarding its optimal treatment. While the use of corticosteroids in the treatment of chronic subdural hematoma is not currently accepted by the neurosurgical community, there is enough evidence in the literature that supports its use. In bCSDH the unilateral burr hole evacuation of the larger of the subdural collections followed by a course of corticosteroids seems to be an effective and safer course of action in the management of bilateral chronic subdural hematoma.

Chronic traumatic encephalopathy: an update review

Chronic traumatic encephalopathy is a progressive neurodegenerative disease occurring in retired sportspersons who have received several head blows with concussions during their games. The clinical symptoms start with mood disorders and with a progressive evolution into dementia and Parkinsonism. The disease is due to a progressive accumulation of hyperphosphorilated tau in neurons as neurofibrillary tangles, abnormal neurites and inclusions in astrocytes around small vessels. There is a tendency of the lesions to occur in clusters at the sulcal depths of the cerebral cortex. Chronic traumatic encephalopathy has to be differentiated from Alzheimer’s disease, in which head trauma can also increase the illness symptoms. Recently, new tracers in positron emission topography of the brain have been used for a better evaluation of chronic traumatic encephalopathy. There is actually no treatment that allows to cure or to slowdown the evolution of chronic traumatic encephalopathy. However, new treatment studies are recently conducted and in progress.

Loss of vision secondary to toxic optic neuropathy due to gutka overdose: A Case Report

Introduction: Toxic optic neuropathy is defined as the damage caused by a toxin to the optic nerve fibers. There is a vast list of toxins that may lead to optic neuropathies. One of the toxins among this list is tobacco. Gutka being an oral form of tobacco, however, has not been previously related to optic neuropathy. Case presentation: We present a case of a 22-year-old male who presented with decreased far vision and gradually increasing photophobia. He had a history of gutka usage, a form of smokeless tobacco. Investigations revealed a central scotoma on FOV, a swollen optic disc on OCT and deranged Liver function tests. A diagnosis of RIGHT + LEFT optic neuropathy secondary to a chemical toxic was made, which in this case, was gutka. Conclusion: Consumption of gutka can lead to irreversible toxic optic neuropathy.

Twist drill aspiration of chronic subdural hematoma at the Ignace Deen hospital of Conakry

Bedside percutaneous twist drill aspiration (TDA) is described as a surgical method of management of Chronic subdural hematoma (CSDH) and appear to be a reasonable approach in low medical resources environment. We report the results of TDA of CSDH in a single tertiary centre in Conakry Republic of Guinea in West Africa, for the period March 2015 to October 2017. The charts and medical record of 38 cases of CSDH treated with TDA were collected retrospectively, with a mean follow-up of 84.2 days. The outcome data assessed were neurologic status evaluated by the follow-up Markwalder grading scale (MGS: 0=normal to 4=coma), recurrence, infection and mortality. The Male-Female ratio was 1.3:1. Mean age at diagnosis was 78.2+/-12 years. Traumatic brain injury (TBI) was identified as causal in 28.2% of cases studied. All patients were operated on under local anesthesia and had a postoperative drain left in place for 3 days. The mean postoperative MGS was 1.06, up from a mean preoperative MGS of 3.7. Two cases of recurrence occurred subsequent to TDA causing death and three other patients died from unknown causes during the follow-up period. No cases of post-operative infection were diagnosed during the follow-up. Our study shows that Bedside TDA appears to be a suitable alternative to burr hole craniotomies in urgent cases of CSDH in the low socio-economic setting, where a surgical theatre is not always available.

Isolated abducens nucleus syndrome due to pontine tegmentum infarction

Introduction: Abnormalities of horizontal gaze could be caused by damage of the abducens nucleus due to ischemic lesion. We report a patient with isolated horizontal gaze palsy as a result of a small ischemic lesion of the pontine tegmentum. Observation: A 61-year-old man, with medical history of diabetes mellitus, dyslipidemia and high blood pressure, was hospitalized after 12 hours of transient dizziness and diplopia. On examination, he had conjugate eye deviation to the right side with horizontal gaze paralysis toward controlateral side. Vertical eye movements, convergence and pupillary reflex were preserved with no peripheral facial palsy. Brain MRI revealed a small lesion in the left pontine tegmentum. Patient received aspirin with atorvastatin and the gaze palsy has been disappeared three weeks later. Discussion: Conjugate lateral eye movement paralysis is commonly attributed to lesions of the caudal pons involving the abducens nucleus. horizontal gaze palsy is often associated to an ipsilateral peripheral facial palsy. In our case, the left lateral gaze palsy was isolated. The pontine lesion should be strictly confined the abducens nucleus which is extremely rare. the outcome of eye movement deviation in brainstem lesions is favorable within few weeks. Conclusion: Our case provides evidence that small pontine lesions can damage the abducens nerve nucleus without causing ipsilateral peripheral facial palsy.

The brain microbiota as it relates to the orch or theory of consciousness

t is proposed to incorporate the concepts of brain microbiota and microbial consciousness in the Orchestrated Objective Reduction (Orch OR) theory of human consciousness with the goal of increasing its explanatory and predictive powers. If consciousness arises from quantum computations in cytoskeletal structures inside human neurons, there is no theoretical impediment at hypothesizing that it might also occur in the cytoskeletal structures of the microbes resident in the human brains. If the concept of the brain microbiota is integrated in a general Orch OR theory, its explanatory and predictive powers would be vastly increased.