1921
Volume 98, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

Cerebral malaria is a severe complication of falciparum malaria that occurs infrequently in adults. Here, we describe the case of a 21-year-old man who presented with fever and headache 13 days after returning from a 12-day trip to Kenya and was subsequently diagnosed with falciparum malaria. Complications of cerebral malaria developed within 1 day after the initiation of therapy with intravenous quinine, and the patient entered a deep coma. Magnetic resonance angiography (MRA) revealed multiple vasoconstrictions in his brain. The resulting neurocognitive disorders that persisted after parasite clearance improved gradually, as confirmed by MRA, enabling the patient to perform activities of daily living upon discharge. In this case of cerebral malaria, the MRA findings indicated the involvement of reversible cerebral vasoconstriction syndrome.

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References

  1. Idro R, Marsh K, John CC, Newton CR, , 2010. Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome. Pediatr Res 68: 267274. [Google Scholar]
  2. Dugbartey AT, Spellacy FJ, Dugbartey MT, , 1998. Somatosensory discrimination deficits following pediatric cerebral malaria. Am J Trop Med Hyg 59: 393396. [Google Scholar]
  3. Hawkes M, Elphinstone RE, Conroy AL, Kain KC, , 2013. Contrasting pediatric and adult cerebral malaria: the role of the endothelial barrier. Virulence 4: 543555. [Google Scholar]
  4. Miller TR, Shivashankar R, Mossa-Basha M, Gandhi D, , 2015. Reversible cerebral vasoconstriction syndrome, part 1: epidemiology, pathogenesis, and clinical course. AJNR Am J Neuroradiol 36: 13921399. [Google Scholar]
  5. Eisenhut M, , 2015. The evidence for a role of vasospasm in the pathogenesis of cerebral malaria. Malar J 14: 405. [Google Scholar]
  6. Lindegaard K-F, Nornes H, Bakke SJ, Sorteberg W, Nakstad P, , 1989. Cerebral vasospasm diagnosis by means of angiography and blood velocity measurements. Acta Neurochir (Wien) 100: 1224. [Google Scholar]
  7. John CC, Bangirana P, Byarugaba J, Opoka RO, Idro R, Jurek AM, Wu B, Boivin MJ, , 2008. Cerebral malaria in children is associated with long-term cognitive impairment. Pediatrics 122: e92e99. [Google Scholar]
  8. Varney NR, Roberts RJ, Springer JA, Connell SK, Wood PS, , 1997. Neuropsychiatric sequelae of cerebral malaria in Vietnam veterans. J Nerv Ment Dis 185: 695703. [Google Scholar]
  9. Carter JA, Mung’ala-Odera V, Neville BG, Murira G, Mturi N, Musumba C, Newton CR, , 2005. Persistent neurocognitive impairments associated with severe falciparum malaria in Kenyan children. J Neurol Neurosurg Psychiatry 76: 476481. [Google Scholar]
  10. Holding PA, Stevenson J, Peshu N, Marsh K, , 1999. Cognitive sequelae of severe malaria with impaired consciousness. Trans R Soc Trop Med Hyg 93: 529534. [Google Scholar]
  11. Carter JA, Lees JA, Gona JK, Murira G, Rimba K, Neville BG, Newton CR, , 2006. Severe falciparum malaria and acquired childhood language disorder. Dev Med Child Neurol 48: 5157. [Google Scholar]
  12. John CC, Panoskaltsis-Mortari A, Opoka RO, Park GS, Orchard PJ, Jurek AM, Idro R, Byarugaba J, Boivin MJ, , 2008. Cerebrospinal fluid cytokine levels and cognitive impairment in cerebral malaria. Am J Trop Med Hyg 78: 198205. [Google Scholar]
  13. Potchen MJ, 2012. Acute brain MRI findings in 120 Malawian children with cerebral malaria: new insights into an ancient disease. AJNR Am J Neuroradiol 33: 17401746. [Google Scholar]
  14. Looareesuwan S, Wilairatana P, Krishna S, Kendall B, Vannaphan S, Viravan C, White NJ, , 1995. Magnetic resonance imaging of the brain in patients with cerebral malaria. Clin Infect Dis 21: 300309. [Google Scholar]
  15. Hajj-Ali RA, Calabrese LH, , 2014. Diagnosis and classification of central nervous system vasculitis. J Autoimmun 48–49: 149152. [Google Scholar]
  16. Milner DA, Jr Whitten RO, Kamiza S, Carr R, Liomba G, Dzamalala C, Seydel KB, Molyneux ME, Taylor TE, , 2014. The systemic pathology of cerebral malaria in African children. Front Cell Infect Microbiol 4: 104. [Google Scholar]
  17. Ducros A, , 2012. Reversible cerebral vasoconstriction syndrome. Lancet Neurol 11: 906917. [Google Scholar]
  18. Mohanty S, 2017. Magnetic resonance imaging of cerebral malaria patients reveals distinct pathogenetic processes in different parts of the brain. mSphere, 2: doi: 10.1128/mSphere.00193-17. [Google Scholar]
  19. Newton CR, Marsh K, Peshu N, Kirkham FJ, , 1996. Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria. Pediatr Neurol 15: 4149. [Google Scholar]
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  • Received : 22 Aug 2017
  • Accepted : 26 Oct 2017

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