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Am. J. Trop. Med. Hyg., 81(4), 2009, pp. 545-547
doi:10.4269/ajtmh.2009.07-0411;
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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Cerebral Malaria: A New Way Forward with Magnetic Resonance Imaging (MRI)

Sornchai Looareesuwan{dagger}, Jiraporn Laothamatas, Truman R. Brown, AND Gary M. Brittenham*
Department of Clinical Tropical Medicine and Hospital for Tropical Diseases, Faculty of Tropical Medicine, and Department of Radiology, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand; Departments of Radiology and Biomedical Engineering and of Pediatrics and Medicine, College of Physicians and Surgeons, Columbia University, New York, New York

Magnetic resonance studies offer a new way through the impasse that now seems to block further progress in disentangling the pathogenesis and improving the treatment of cerebral malaria, a catastrophic neurologic complication of infection with Plasmodium falciparum. The underlying mechanisms responsible for coma in cerebral malaria are still unknown and the relative contributions of the microvascular sequestration of infected erythrocytes, the inflammatory response to P. falciparum, disordered hemostasis, and other factors remain controversial. For more than a century, neuropathologic studies have provided the basis for concepts of causation of cerebral malaria. Magnetic resonance techniques now offer non-invasive means of determining essential anatomic, metabolic, biochemical, and functional features of the brain in patients with cerebral malaria during life that could transform our understanding of the pathogenesis of cerebral malaria and lead to the development of new neuroprotective treatments.

Received August 11, 2007. Accepted for publication June 25, 2009.

Disclosure: T. R. Brown wishes to disclose that he has served as a consultant to Philips Medical Systems, a manufacturer of MRI equipment. This statement is made in the interest of full disclosure and not because the author considers this to be a conflict of interest.

* Address correspondence to Gary M. Brittenham, Columbia University College of Physicians and Surgeons, Children’s Hospital of New York, Room CHN 10-08, 3959 Broadway, New York, NY 10032. E-mail: gmb31{at}columbia.edu

{dagger} Deceased.

Authors’ addresses: Jiraporn Laothamatas, Advanced Diagnostic Imaging and Image-guided Minimally Invasive Therapy Center, Sirikit Medical Building, Ramathibodi Hospital, Mahidol University, Rama VI Road, Ratchatewi, Bangkok 10400, Thailand, Tel: +66-2-246-0024, Fax: +66-2-354-7233, E-mail: laothamatas{at}gmail.com. Truman R. Brown, Columbia University College of Physicians and Surgeons, Hatch Magnetic Resonance Research Center, 710 West 168th Street, New York, NY 10032, Tel: 212-305-1864, Fax: 212-342-5773, E-mail: trb11{at}columbia.edu. Gary M. Brittenham, Columbia University College of Physicians and Surgeons, Children’s Hospital of New York, Room CHN 10-08, 3959 Broadway, New York, NY 10032, Tel: 212-305-7005, Fax: 212-305-8428, E-mail: gmb31{at}columbia.edu.






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Copyright © 2009 by the American Society of Tropical Medicine and Hygiene.