A thirty-one year-old Sri Lankan man presented with a two-month history of progressive pan-cerebellar syndrome, following allogeneic stem cell transplantation. This curative-intent therapy was performed in the context of an underlying acute myeloid leukemia. During the post-transplant period, patients are extremely vulnerable, especially due to the immunologic fluctuations. Reaching equilibrium is crucial, preventing complications of both extremes of the immunologic response, such as opportunistic infections or graft versus host disease. Numerous aetiologies were considered in the differential diagnosis of this pan-cerebellar syndrome. Most of those conditions mandate a prompt management, because of their reversible or lethal nature. Our thorough investigation process was a race against time. Excluding “Red Flags” remains the priority. Mindfulness and time will eventually lead to the proper diagnosis. We discuss our structured investigation process emphasizing on the key element: a “Systematic Approach”.

Study nature of epidemiological risk factors and patterns of distribution of mortality from Alzheimers (MA) in 160 countries. An exponential Malthus model was used to construct adequate approximations of statistical data. Proportionality of average lifetime after 55 years (?t) to education index (?) was established. Ranking of countries by increasing value of ??t showed that MA depends exponentially on ??t and all countries can be divided into three groups in accordance with level of their economic development. In series of countries of low, medium and highly developed, their average values of MA increase exponentially. Growth of MA in developed countries in post-industrial epoch was explained by emergence of a new risk factor Alzheimers of a mental nature. A mismatch of complexity or, on contrary, primitiveness of profession with level of mental development of worker, provokes development of chronic stress in him, fraught with pathologies of cognitive function metabolism in elderly. The geography of Alzheimers disease was explained by the dependence of the human mentality on latitudinal climate change and on the chiral factor of a solar nature acting at night on a sleeping person.

Summary: Epilepsy is one of the most frequent chronic neurological pathologies, with high incidence and prevalence worldwide. A third of these patients are resistant to treatment, which is known as refractory epilepsy. Most of these patients suffer epilepsy secondary to epileptogenic lesions, where the surgery is the only treatment that could cure epilepsy. The goal of epilepsy surgery is to remove the epileptogenic area with preservation of eloquent areas, and here the surgical experience, the neuroimaging technology and the availability of image-guided surgery systems known as a neuronavigator plays a key role. Objectives: To demonstrate the usefulness of neuronavigation in pre-surgical planning and in the surgery of refractory epilepsy. Method: A cross-sectional and analytical descriptive study was conducted based on 47 surgeries performed (12 resective, 32 palliative and 3 diagnostic) in patients with refractory epilepsy and mean age of 9.93 years (SD 4.1). In 27 patients (57.44%) the neuronavigator was used. In the group of patients operated with neuronavigation, the surgical time decreased by 47.17 minutes (p = 0.022), the amount of bleeding by 111.41 milliliters (p = 0.011) and the days of hospitalization by 6.68 days (p = 0.005), compared with the group operated without neuronavigation. Complications in the neuronavigation group were 29.63% compared to 65% in the group operated without neuronavigation (p = 0.034). Conclusions: In our series, the use of the neuronavigator in the planning and development of the surgery had a significant impact by reducing the amount of bleeding lost, the surgical time, the days of hospitalization, and the post-surgical complications.