Resumo Introdução: A pneumonia de aspiração é uma complicação grave do acidente vascular cerebral (AVC), estan-do relacionada com a sua gravidade e comprometimento funcional, e aumentando a mortalidade, tempos de hospitalização e custos em saúde. O objetivo deste estudo é relacionar a pneumonia de aspiração com o tipo e gravidade do AVC isquémico e respetivas consequências e desfechos. Material e Métodos: Estudo retrospetivo que analisou 1116 doentes admitidos numa Unidade de AVC de Portugal admitidos entre 2017 e 2019, selecionando e caracterizando os de etiologia isquémica, de acordo com a classificação de Bamford. O estado funcional foi quantificado pela escala modificada de Rankin e pela de Barthel, a gravidade do AVC pela escala do National Institutes of Health, e a disfagia pelo Gugging Swallowing Screen. Estas escalas foram determinadas à admissão e à alta. A pneumonia de aspiração foi identificada com base em critérios clínicos, laboratoriais e radiológicos. Resultados: População de 937 indivíduos com predo-mínio masculino (51,5%) e idade média 75,6 anos. Pneumonia de aspiração presente em 19,5%. Enfartes totais da circulação anterior com maior prevalência de pneumonia de aspiração (74,3%). Estados funcionais, gravidade do AVC e grau de disfagia foram piores no grupo com pneumonia de aspiração. Taxa de mortalidade global de 11,6%, com demora média 11,0 dias, sendo significativamente mais altas no grupo com pneumonia de aspiração (40,4% e 13,8 dias, respetivamente). Discussão/Conclusão: A pneumonia de aspiração está relacionada com a gravidade do AVC, estado funcional e grau de disfagia, comportando taxas de mortalidade e demoras médias mais altas.

Abstract Introduction: Aspiration pneumonia is a severe complication of stroke, related to higher stroke severity, functional impairment and dysphagia grade, increasing mortality rate, length of hospitalization and health costs. The study aims to analyse the relationship between aspiration pneumonia, the clinical type and severity of ischemic stroke and its consequences and outcomes. Material and Methods: A retrospective study aanalysed 1116 patients admitted to a Portuguese stroke unit between 2017 and 2019, selecting and characterizing ischemic strokes according to Bamford Stroke Classification. The functional status was quantified with the modified-Rankin and Barthel scales, the severity of stroke was evaluated with the National Institutes of Health Stroke Scale, and the dysphagia status was accessed with the Gugging Swallowing Screen. These scales were evaluated at admission and discharge. Aspiration pneumonia was identified based on clinical, laboratory and radiologic findings. Results: A population of 937 individuals (51.5%), and ave-rage age 75.6 years old. Prevalence of aspiration pneumonia of 19.5%. Total anterior circulation infarction with higher rate of aspiration pneumonia (74.3%). The functional status, severity of stroke, and grade of dysphagia were worse in the aspiration pneumonia group. The overall mortality rate was 11.6%, with an average length of 11.0 days of hospitalization, being statistically significant (p < 0.01) in the aspiration pneumonia group (40.4% and 13.8 days, respectively). Discussion/Conclusion: Aspiration pneumonia is related to the severity of stroke, functional status, and grade of dys-phagia, being related to higher mortality rates and longest length of stay.

Abstract: Brucellosis is a commonly diagnosed zoonosis and neurological involvement is rare. A 30-year-old woman presented with a pulsatile headache that was exacerbated by the Valsalva maneuver and refractory to analgesic therapy. The patient also had nausea, cough, and coryza that evolved over 7 days. The neurological examination was unremarkable. Thrombosis of the lateral and sigmoid sinus and ipsilateral internal jugular vein were diagnosed and anticoagulation therapy was started. Brucella spp was identified in a sample of cerebrospinal fluid (CSF); five months after treatment with rifampicin and doxycycline, CSF was sterile. Cerebral venous thrombosis is a very uncommon sign of brucellosis.