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Updated: May 26, 2026
09:04
In Vivo Tracking of Edema Development and Microvascular Pathology in a Model of Experimental Cerebral Malaria Using Magnetic Resonance Imaging
Published on: June 8, 2017
Sequestration and microvascular congestion are associated with coma in human cerebral malaria
Mark J Ponsford1, Isabelle M Medana, Panote Prapansilp
1Nuffield Department of Clinical Laboratory Sciences, The John Radcliffe Hospital, University of Oxford, United Kingdom.
The Journal of Infectious Diseases
|December 31, 2011
Summary
Severe Plasmodium falciparum malaria pathogenesis is unclear. Parasite sequestration in brain blood vessels contributes to cerebral malaria coma by causing microvascular congestion.
Area of Science:
- Malariology
- Neurology
- Pathology
Background:
- The exact causes of coma in severe Plasmodium falciparum malaria are not fully understood.
- Microvascular obstruction by sequestered parasitized red blood cells (pRBCs) is a proposed mechanism for cerebral malaria (CM).
Purpose of the Study:
- To investigate the role of microvascular sequestration and congestion in the pathogenesis of cerebral malaria coma.
Main Methods:
- Quantitative postmortem microscopy was used to examine brain sections from Vietnamese adults with and without cerebral malaria.
- Clinicopathological correlations were performed to link microscopic findings with clinical data.
Main Results:
- Cerebral microvasculature sequestration of pRBCs was significantly higher in patients with CM compared to non-CM patients.
- Both pRBC sequestration and microvascular congestion were associated with deeper coma and shorter survival times.
- Microvascular congestion and sequestration were independent predictors of CM diagnosis.
Conclusions:
- Increased microvascular congestion, driven by parasite sequestration, is a key feature accompanying coma in cerebral malaria.
- These findings elucidate a critical pathological mechanism in severe malaria affecting the brain.
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