Mitochondrial dysfunction mediates neuronal cell response to DMMB photodynamic therapy.

Photodynamic therapy (PDT) is a process in which a photosensitizer (PS) is exposed to specific wavelengths and generates reactive oxygen species (ROS) which act within nanometers. The low invasive nature and directed cytotoxicity of this approach render it attractive to the treatment of different conditions, including the ones that affect the central nervous system (CNS). The effect of PDT on healthy neurons is one main concern over its use in the CNS, since neuronal-like cells were shown to be particularly sensitive to certain PSs. Among available PSs, 1,9-dimethyl-methylene blue (DMMB) stands out as being resistant to reduction to its inactive leuco form and by being able to produce high levels of singlet­oxygen. In this study, we aimed to investigate DMMB photodamage mechanisms in the hippocampal cell line HT22. Our results demonstrate that DMMB-PDT decrease in cell viability was linked with an increase in cell death and overall ROS production. Besides, it resulted in a significant increase in mitochondrial ROS production and decreased mitochondria membrane potential. Furthermore, DMMB-PDT significantly increased the presence of acidic autolysosomes, which was accompanied by an increase in ATG1 and ATG8 homologue GaBarap1 expression, and decreased DRAM1 expression. Taken together our results indicated that mitochondrial and autophagic dysfunction underlie DMMB-PDT cytotoxicity in neuronal cells.

A importância da reabilitação pulmonar em pacientes com COVID-19 / The importance of pulmonary rehabilitation in patients with COVID-19

Introdução: Uma doença altamente infecciosa do trato respiratório, a doença de coronavírus 2019 (COVID-19) pode causar disfunção respiratória, física e psicológica em pacientes. Portanto, a reabilitação pulmonar é crucial para pacientes admitidos e que recebem alta da COVID-19. As sequelas de longo prazo são desconhecidas, mas as evidências de surtos anteriores de CoV demonstram comprometimento da função pulmonar e física, redução da qualidade de vida e sofrimento emocional. Métodos: Trata-se de uma revisão sistemática da literatura realizada através de busca digital em artigos publicados em revistas impressas e eletrônicas, ensaios clínicos, estudos randomizados, revisões sistemáticas, no período compreendido entre os anos de 2003 e 2020. Resultados: Muitos sobreviventes da COVID-19 que necessitam de cuidados críticos podem desenvolver comprometimentos psicológicos, físicos e cognitivos. Conclusão: Existe uma clara necessidade de orientação sobre a reabilitação dos sobreviventes da COVID-19. (AU)

Introduction: A highly infectious disease of the respiratory tract, coronavirus disease 2019 (COVID-19) can cause respiratory, physical, and psychological dysfunction in patients. Therefore, pulmonary rehabilitation is crucial for patients admitted and discharged from COVID-19. The long-term sequelae of COVID-19 are unknown, but evidence of previous CoV outbreaks demonstrates impaired lung and physical function, reduced quality of life and emotional distress. Methods: This is a systematic review of the literature carried out through digital bibliographic search of scientific articles published in printed and electronic journals, clinical trials, randomized studies, systematic reviews, in the period between the years 2003 and 2020. Results: Many survivors of COVID-19 that require critical care can develop psychological, physical, and cognitive impairments. Conclusion: There is a clear need for guidance on the rehabilitation of COVID-19 survivors. (AU)

Improved immobilization of lipase from Thermomyces lanuginosus on a new chitosan-based heterofunctional support: Mixed ion exchange plus hydrophobic interactions.

In this study, a new mixed heterofunctional support (Chit-GA-Gly) has been prepared by sequential activation of chitosan hydrogel (Chit) with glutaraldehyde (GA) and further functionalization with glycine (Gly). The immobilization of the lipase from Thermomyces lanuginosus (TLL) on this support was compared with that on GA-activated Chit hydrogel (Chit-GA). The supports have been characterized by FT-IR, zeta potential and TG analyses. A similar maximum lipase loading of 53-55 mg per gram of support has been obtained for both supports. Both biocatalysts retained ≈40% of their initial activity after 48 h of incubation at 50 °C in heptane, toluene or iso-octane. The immobilization of TLL on Chit-GA proceeded via preferential covalent attachment (95%) and a combined ion exchange (cationic and anionic) and hydrophobic adsorption was observed using Chit-GA-Gly. TLL immobilized on Chit-GA-Gly was ≈4-times more active than when immobilized on Chit-GA in both olive oil emulsion hydrolysis and alkyl palmitate synthesis via esterification. Isoamyl palmitate synthesis in iso-octane at 50 °C using this new biocatalyst gave a maximum acid conversion of 85% after 90 min of reaction. After nine consecutive esterification batches, the biocatalyst retained around 40% of its initial activity.

Influence of climatic variables on the Aedes aegypti and Culex quinquefasciatus populations in Mato Grosso, Brazil.

INTRODUCTION: Aedes aegypti and Culex quinquefasciatus are vector species responsible for the transmission of important arboviruses. METHODS: Adult mosquitoes were collected in the urban areas of four municipalities in Mato Grosso within 1 year. RESULTS: A total of 19,110 mosquitoes were collected. Among them, 16,578 (86,8%) were C. quinquefasciatus (44% female and 56% male); 2,483 (13%), A. (Stegomyia) aegypti (54% female and 46% male); and 49 (0,30%), from the genus Psorophora, Anopheles, Coquilettidia, and Sabethes. A significant correlation was observed between the number of mosquitoes from all species and dew point (female mosquitoes, p = 0.001; male mosquitoes, p = 0.001). CONCLUSIONS: The results of this study may be used as environmental indicators of mosquito populations.

Influence of climatic variables on the Aedes aegypti and Culex quinquefasciatus populations in Mato Grosso, Brazil

Abstract INTRODUCTION: Aedes aegypti and Culex quinquefasciatus are vector species responsible for the transmission of important arboviruses. METHODS: Adult mosquitoes were collected in the urban areas of four municipalities in Mato Grosso within 1 year. RESULTS: A total of 19,110 mosquitoes were collected. Among them, 16,578 (86,8%) were C. quinquefasciatus (44% female and 56% male); 2,483 (13%), A. (Stegomyia) aegypti (54% female and 46% male); and 49 (0,30%), from the genus Psorophora, Anopheles, Coquilettidia, and Sabethes. A significant correlation was observed between the number of mosquitoes from all species and dew point (female mosquitoes, p = 0.001; male mosquitoes, p = 0.001). CONCLUSIONS: The results of this study may be used as environmental indicators of mosquito populations.

Synthesis and role of melanin for tolerating in vitro rumen digestion in Duddingtonia flagrans, a nematode-trapping fungus.

We describe the synthesis and a function of melanin in Duddingtonia flagrans, a nematode-trapping fungus. We tested various culture media treated with L-DOPA, glucose and tricyclazole on fungal growth and melanin distribution using infrared spectroscopy (IS), electron paramagnetic resonance (EPR) and transmission electron microscopy (TEM). In vitro rumen digestion was used to test the environmental stress and then to evaluate the capacity of this fungus to trap nematode larvae. The growth and melanization of the fungus after 21 days of incubation at 30°C were best in Sabouraud dextrose medium. IS indicated the presence of melanin in D. flagrans, with similar bands for commercial melanin used as a control, and assigned the values obtained by EPR (g of 2.0051 ± 0.0001) to the production of melanin by the fungus. TEM indicated that melanin was produced in melanosomes but was not totally inhibited by tricyclazole. Within the limits of experimental error, the predatory activity of fungus treated with tricyclazole was drastically affected after 27 h of in vitro anaerobic stress with rumen inoculum. The deposition of melanin particles on the fungal cell wall contributed to the maintenance of D. flagrans predatory abilities after in vitro anaerobic ruminal stress.

Preparation, functionalization and characterization of rice husk silica for lipase immobilization via adsorption.

Silica has been extracted from rice husks via a simple hydrothermal process and functionalized with triethoxy(octyl)silane -OCTES (Octyl-SiO2) and (3-aminopropyl)triethoxysilane - 3-APTES (Amino-SiO2), with the aim of using it as support to immobilize lipase from Thermomyces lanuginosus (TLL) via adsorption. The supports have been characterized by particle size distribution and elemental analyses, XRD, TGA, SEM, AFM and N2 physisorption so as to confirm their functionalization. Effect of pH, temperature, initial protein loading and contact time on the adsorption process has been systematically evaluated. Maximum immobilized protein loading of 12.3 ± 0.1 mg/g for Amino-SiO2 (5 mM buffer sodium acetate at pH 4.0, 25 °C and initial protein loading of 20 mg/g) and 21.9 ± 0.1 mg/g for Octyl-SiO2 (5 mM buffer sodium acetate at pH 5.0, 25 °C and initial protein loading of 30 mg/g) was observed. However, these biocatalysts presented similar catalytic activity in olive oil emulsion hydrolysis (between 630 and 645 U/g). TLL adsorption was a spontaneous process involving physisorption. Experimental data on Octyl-SiO2 and Amino-SiO2 adsorption were well-fitted to the Langmuir isotherm model. It was also investigated whether these biocatalysts could synthesize cetyl esters via esterification reaction. Thus, it was found that cetyl stearate synthesis required 100-110 min of reaction time to attain maximum conversion percentage (around 94%). Ester productivity of immobilized TLL on Amino-SiO2 was 1.3-3.1 times higher than Octyl-SiO2.

The clinical measure of forefoot-shank alignment partially reflects mechanical properties of the midfoot joint complex.

BACKGROUND: The clinical measure of forefoot-shank alignment (FSA) predicts the amount of foot pronation during weight-bearing tasks. This may be mediated by a relationship between FSA and the mechanical resistance of the midfoot joint complex (MFJC) to forefoot inversion, which is a component of weight-bearing foot pronation. OBJECTIVE: To investigate if the clinical measure of FSA is associated with MFJC mechanical resistance to inversion. DESIGN: Cross-sectional observational study. METHOD: Forty-six healthy individuals (27 males; 19 females) with mean age of 26.4 years (SD 5.3) participated in this study. FSA was measured with photographs. The resistance torque of the MFJC against inversion was measured with a specially designed device. Mean torque, mean torque normalized by body mass, and joint resting position were calculated as variables related to MFJC mechanical resistance. Correlation analyses were carried out to test the association between each MFJC resistance variable and the FSA (α = 0.05). RESULTS: /findings: There were significant moderate correlations of FSA with mean torque (r = -0.44, p = 0.002), mean normalized torque (r = -0.42, p = 0.004) and resting position (r = 0.39, p = 0.007). The clinical measure of FSA is associated to the mechanical resistance of the MFJC: (a) the greater the FSA, the smaller the resistance torques; (b) the greater the FSA, the more inverted the forefoot resting position. CONCLUSIONS: These results showed that the clinical measure of FSA is moderately related to mechanical properties of the MFJC.

Foot pronation during walking is associated to the mechanical resistance of the midfoot joint complex.

BACKGROUND: The demonstration of the relationship between midfoot passive mechanical resistance and foot pronation during gait may guide the development of assessment and intervention methods to modify foot motion during gait and to alter midfoot passive mechanical resistance. RESEARCH QUESTION: Is foot pronation during the stance phase of gait related to the midfoot passive mechanical resistance to inversion? METHODS: The resistance torque and stiffness provided by midfoot soft tissues of 33 participants (21 females and 12 males) with average of 26.21 years were measured. In addition, the participants' forefoot and rearfoot kinematic data during the stance phase of gait were collected with the Qualisys System (Oqus 7+). Correlation Coefficients were calculated to test the association between kinematic variables representing pronation (forefoot-rearfoot inversion, forefoot-rearfoot dorsiflexion and rearfoot-shank eversion) and maximum resistance torque and maximum stiffness of the midfoot with α = 0.05. RESULTS: Reduced maximum midfoot resistance torque was moderately associated with increased forefoot-rearfoot inversion peak (p = 0.029; r = 0.38), with forefoot-rearfoot dorsiflexion peak (p = 0.048; r = -0.35) and with rearfoot-shank eversion peak (p = 0.008; r = -0.45). Maximum midfoot stiffness was not associated to foot pronation. SIGNIFICANCE: The smaller the midfoot resistance torque, the greater the forefoot-rearfoot inversion and dorsiflexion peaks and the rearfoot-shank eversion peak during gait. The findings suggest the existence of a relationship between foot pronation and midfoot passive mechanical resistance. Thus, changes in midfoot passive mechanical resistance may affect foot pronation during gait.

Bean coproduct as source of protein in dairy cows diets / Coproduto do feijão como fonte proteica em dietas para vacas leiteiras

The objective of this study was to evaluate the supplementation of dairy cows with different protein sources in relation to intake, digestibility, production and chemical composition of milk. For this, eight crossbred cows (Hostein x Gir) were used, distributed in two simultaneous latin squares (4x4). The treatments used were: bean coproduct, soybean meal, sunflower meal and cottonseed meal. Four variance-covariance structures were tested by means of the Akaike criterion corrected to determine the best fit to the data, and afterwards they were submitted to analysis of variance, and the means of the treatments were compared by the Tukey's test, at 5% probability. Only intakes of crude protein and crude fat were influenced by the treatments, for the digestibility, regardless of the evaluated nutrient, the soybean meal was the best treatment or was among the best, a behavior also observed for milk production. Thus, it was concluded that soybean meal is the best source of protein among the supplements used, and the bean coproduct stands out as a low-cost protein source but should not fully replace soybean meal, especially in animal categories of higher nutritional requirement.

Objetivou-se com este estudo avaliar a suplementação de vacas leiteiras com diferentes fontes proteicas em relação ao consumo, digestibilidade, produção e composição química do leite. Para tanto, utilizou-se oito vacas mestiças (Holandês x Gir), distribuídas em dois quadrados latinos (4x4) simultâneos. Os tratamentos utilizados foram: coproduto do feijão, farelo de soja, farelo de girassol e farelo de algodão. Foram testadas quatro estruturas de variância-covariância por meio do critério de Akaike corrigido para determinar o melhor ajuste aos dados, e posteriormente foram submetidas à análise de variância, sendo as médias dos tratamentos comparadas pelo teste de Tukey, a 5% de probabilidade. Apenas os consumos de proteína bruta e gordura bruta foram influenciados pelos tratamentos, já em relação a digestibilidade, independente do nutriente avaliado o farelo de soja foi o melhor tratamento ou esteve entre os melhores, comportamento este observado também para a produção de leite. Com isso, concluiu-se que dentre os suplementos utilizados o farelo de soja é a melhor fonte proteica, e o coproduto de feijão se destaca como uma fonte proteica de baixo custo, mas que deve substituir integralmente o farelo de soja, principalmente em categorias animais com alta exigência nutricional.

Impacts of citrus pulp addition and wilting on elephant grass silage quality / Impacto da adição de polpa citríca e do emurchecimento na qualidade da silagem de capim-elefante

The objective of this work was to evaluate the use of citrus pulp addition and wilting on fermentative characteristics, chemical composition as well as gas and effluent losses of elephant grass silage. The elephant grass (70 growth days) was collected manually; one portion was immediately chopped and another one was allowed to wilt in the sun for a period of 6 h and subsequently chopped for the production of silage. Experimental PVC silos (10 cm diameter x 30 cm height) were used and sand bags were placed at the bottom of the silos. Citrus pulp (80 g kg-1 of MN) was added at the beginning of ensilage. The ensiled material was manually compressed to provide a specific mass of approximately 600 kg m-3 of silage. After 60 days, the silos were opened; gas and effluent losses were calculated and we determined pH, dry matter (DM), crude protein(CP), neutral detergent fibre (NDF), lignin, ammonia nitrogen, ash and in vitro dry matter digestibility (IVDMD). We added 0 or 80 g kg-1 of citrus pulp to wilted and un-wilted elephant grass. We used a completely randomised design with a 2 x 2 factorial arrangement (wilted or un-wilted) x (with or without citrus pulp), totalling treatments with five repetitions. Average values were compared using the F test with a probability of 5%. The addition of citrus pulp resulted in reduced levels of NDF, lignin, ash, N-NH3 and pH and in increased values of DM and IVDMD of silages. Wilting increased the DM, NDF and lignin values and reduced the concentrations of CP, IVDMD and N-NH3. Based on our results, citrus pulp addition improves the chemical composition of elephant grass silage and increases its in vitro dry matter digestibility.

Objetivou-se avaliar o uso de polpa cítrica e do emurchecimento sobre as características fermentativas, composição química e perdas de silagens de capim-elefante. O capim-elefante foi colhido manualmente com cerca de 70 dias de rebrota, uma parte foi picada imediatamente e outra foi emurchecida ao sol por 6 horas e posteriormente picado para confecção das silagens. Foram utilizados silos experimentais de PVC com 10 cm de diâmetro e 30 cm de altura, no fundo dos silos foram colocados sacos com areia. A polpa cítrica foi incluída na base de 80 g kg-1 da matéria natural no momento da ensilagem. O material ensilado foi compactado manualmente de forma a proporcionar massa específica de aproximadamente 600 kg m-3 de silagem. No momento da ensilagem foram pesados os silos vazios, os sacos com areia, o material ensilado e os silos cheios. Após 60 dias os silos foram pesados novamente e logo em seguida abertos. Foram calculadas as perdas por gases e efluentes e determinados o pH, conteúdo de matéria seca, teores de proteína bruta, fibra em detergente neutro (FDN), fibra em detergente ácido (FDA), celulose, hemicelulose e lignina, cinzas, nitrogênio amoniacal e digestibilidade in vitro da matéria seca (DIVMS). Foi utilizado o delineamento inteiramente casualisado em arranjo fatorial 2 (emurchecido ou não) x 2 (com polpa cítrica ou não), 4 tratamentos com 5 repetições, totalizando 20 parcelas. As médias foram comparadas pelo teste F a 5%. O uso de polpa cítrica reduziu os níveis de FDN, lignina, cinzas, N-NH3 e o pH e aumentou a MS e a DIVMS das silagens. O emurchecimento aumentou a MS, FDN e a lignina e reduziu a proteína bruta, DIVMS e N-NH3. O uso da polpa cítrica melhora a composição química e a digestibilidade in vitro da matéria seca de silagens de capim-elefante.

Estimating of gross primary production in an Amazon-Cerrado transitional forest using MODIS and Landsat imagery.

The acceleration of the anthropogenic activity has increased the atmospheric carbon concentration, which causes changes in regional climate. The Gross Primary Production (GPP) is an important variable in the global carbon cycle studies, since it defines the atmospheric carbon extraction rate from terrestrial ecosystems. The objective of this study was to estimate the GPP of the Amazon-Cerrado Transitional Forest by the Vegetation Photosynthesis Model (VPM) using local meteorological data and remote sensing data from MODIS and Landsat 5 TM reflectance from 2005 to 2008. The GPP was estimated using Normalized Difference Vegetation Index (NDVI) and Enhanced Vegetation Index (EVI) calculated by MODIS and Landsat 5 TM images. The GPP estimates were compared with measurements in a flux tower by eddy covariance. The GPP measured in the tower was consistent with higher values during the wet season and there was a trend to increase from 2005 to 2008. The GPP estimated by VPM showed the same increasing trend observed in measured GPP and had high correlation and Willmott's coefficient and low error metrics in comparison to measured GPP. These results indicated high potential of the Landsat 5 TM images to estimate the GPP of Amazon-Cerrado Transitional Forest by VPM.

Molecular identification of Bartonella henselae in a seronegative cat scratch disease patient with AIDS in Rio de Janeiro, Brazil.

Bartonella henselae is associated with a wide spectrum of clinical manifestations, including cat scratch disease, endocarditis and meningoencephalitis, in immunocompetent and immunocompromised patients. We report the first molecularly confirmed case of B. henselae infection in an AIDS patient in state of Rio de Janeiro, Brazil. Although DNA sequence of B. henselae has been detected by polymerase chain reaction in a lymph node biopsy, acute and convalescent sera were nonreactive.

MOLECULAR IDENTIFICATION OF Bartonella henselae IN A SERONEGATIVE CAT SCRATCH DISEASE PATIENT WITH AIDS IN RIO DE JANEIRO, BRAZIL / Identificação molecular de Bartonella henselae em paciente com SIDA soronegativo para doença da arranhadura do gato no Rio de Janeiro, Brasil

Bartonella henselae is associated with a wide spectrum of clinical manifestations, including cat scratch disease, endocarditis and meningoencephalitis, in immunocompetent and immunocompromised patients. We report the first molecularly confirmed case of B. henselae infection in an AIDS patient in state of Rio de Janeiro, Brazil. Although DNA sequence of B. henselae has been detected by polymerase chain reaction in a lymph node biopsy, acute and convalescent sera were nonreactive.

Bartonella henselae está associada a um amplo espectro de manifestações clínicas, incluindo a doença da arranhadura de gato, endocardite, e meningoencefalite, em pacientes imunocompetentes e imunocomprometidos. Relatamos o primeiro caso confirmado por método molecular de B. henselae em um paciente com SIDA no estado do Rio de Janeiro, Brasil. Apesar da sequência de DNA de B. henselae ser detectada pela reação em cadeia da polimerase em uma biópsia do linfonodo, soros das fases aguda e convalescente foram não reativos.

Molecular identification of the agent of Q fever - Coxiella burnetii - in domestic animals in State of Rio de Janeiro, Brazil.

INTRODUCTION: Over the last recent years, the number of Q fever cases have has increased throughout the world. An epidemiological investigation was performed in the area in which the first molecular documentation of Q fever in Brazil was previously reported. METHODS: Indirect immunofluorescence assay (IFA) and PCR of Coxiella burnetii targeting the htpAB gene were performed in samples from 14 dogs (blood); 1 cat (blood); 10 goats (blood, milk, vaginal swab and anal swab); 3 sheep (blood); and 2 horses (blood). RESULTS: Two dogs, two sheep and five goats were seroreactive. DNA was amplified from 6 milk and 2 blood samples from goats and from dogs, respectively. The sequence of the amplicons exhibited 99% sequence similarity with the homologous sequence of the htpAB gene of C. burnetii RSA 331 (GenBank - CP000890). CONCLUSIONS: The results confirm C. burnetii infection in animals in Rio de Janeiro and reinforce the need for the surveillance of Q fever in Brazil.

Detection of serum antibodies against Bartonella species in cats with sporotrichosis from Rio de Janeiro, Brazil.

Cat scratch disease is a zoonosis caused by Bartonella species, transmitted to humans through scratches or bites from infected cats and via direct contact with infected feces. Sporotrichosis, caused by the fungal complex Sporothrix, is transmitted by traumatic inoculation of the fungus. Cats are important in zoonotic transmission. Serum samples from 112 domestic cats with sporotrichosis and 77 samples from healthy cats were analyzed by indirect immunofluorescence assay (IFA), using the commercial kit Bartonella henselae IFA IgG (Bion). The presence of antibodies against feline leukemia virus (FeLV) and of feline immunodeficiency virus (FIV) core antigens was detected using the commercial kit Snap Combo FIV-FeLV (Idexx). The group of animals with sporotrichosis contained 93 males with a median age of 22 months, eight (7.1%) of which were positive for FIV and 15 (13.4%) for FeLV. The group of animals without sporotrichosis contained 36 males with a median age 48 months, 10 (13.0%) of which were positive for FIV and eight (10.4%) for FeLV. Of the 112 cats with sporotrichosis and 77 cats without mycosis, 72 (64.3%) and 35 (45.5%), respectively, were IFA reactive. No association was found between age, sex, FIV/FeLV and the presence of antibodies to Bartonella species. The results suggest that the study population can be considered a potential source of zoonotic infection for both diseases.

Pneumoencéfalo associado a trauma de face: relato de caso / Pneumocephalus associated with facial trauma: a case report

O pneumoencéfalo consiste em um acúmulo de ar no interior da cavidade intracraniana, podendo ou não estar associado à ruptura da dura-máter. Devido à sua localização, os principais sintomas ocorrem em consequência da hipertensão intracraniana, caracterizando cefaleia, convulsão, diminuição do nível de consciência, náusea, vômito, tontura e hemiparesia. O presente trabalho tem o objetivo de relatar um caso clínico de paciente de gênero masculino, 27 anos de idade, vítima de acidente automobilístico com trauma em face e crânio, apresentando, em primeiro atendimento, assimetria facial com afundamento de região zigomática direita, epistaxe sem aparente alteração nasal, diplopia, diminuição de acuidade auditiva esquerda, sem mobilidade ou crepitação óssea à manipulação de terço médio de face e diminuição de acuidade auditiva esquerda evoluindo, em 12 horas, com paralisia e parestesia em hemiface esquerda, cefaleia frontal e tontura após assumir posição ortostática revelando, em TC de crânio, diversas imagens hipodensas em região intracraniana compatível com pneumoencéfalo maciço, realizando acompanhamento clínico deste com involução do caso em 6 dias.

Pneumocephalus consists of an accumulation of air inside the intracranial cavity, and may or may not be associated with the rupture of the dura mater. Due to its location, the main symptoms occur as a result of intracranial hypertension, characterizing headache, seizure, decreased level of consciousness, nausea, vomiting, dizziness and hemiparesis. The present study sets out to report a case of a 27-year-old male patient, a car accident victim with facial and skull trauma, presenting originally a facial asymmetry with sinking of the right zygomatic region, epistaxis with no apparent nasal alteration, diplopia, decreased left hearing acuity, manipulation without mobility or crackling bone of the middle third of the face and progressing in twelve hours to paralysis and numbness in the left hemiface, frontal headache and dizziness in the standing position. A cranial CT scan showed several hypodense images in the intracranial region compatible with massive pneumocephalus. A clinical follow-up revealed involution of the case in 6 days.