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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
Brain magnetic resonance imaging in imported malaria
Andreas M Frölich1, Pinkus Tober-Lau2, Michael Schönfeld1
1Department of Diagnostic and Interventional Neuroradiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
Background:
Previous studies have documented a spectrum of brain magnetic resonance imaging (MRI) abnormalities in patients with cerebral malaria, but little is known about the prevalence of such abnormalities in patients with non-cerebral malaria. The aim of this study was to assess the frequency of brain MRI findings in returning travellers with non-cerebral malaria.
Methods:
A total of 17 inpatients with microscopically confirmed Plasmodium falciparum non-cerebral malaria underwent structural brain MRI at 3.0 Tesla, including susceptibility-weighted imaging (SWI). Presence of imaging findings was recorded and correlated with clinical findings and parasitaemia.
Results:
Structural brain abnormalities included a hyperintense lesion of the splenium on T2-weighted imaging (n = 3) accompanied by visible diffusion restriction (n = 2). Isolated brain microhaemorrhage was detected in 3 patients. T2-hyperintense signal abnormalities of the white matter ranged from absent to diffuse (n = 10 had 0-5 lesions, n = 5 had 5-20 lesions and 2 patients had more than 50 lesions). Imaging findings were not associated with parasitaemia or HRP2 levels.
Conclusion:
Brain MRI reveals a considerable frequency of T2-hyperintense splenial lesions in returning travellers with non-cerebral malaria, which appears to be independent of parasitaemia.
Insights
Brain MRI scans show frequent T2-hyperintense splenial lesions in travelers with non-cerebral malaria. These abnormalities are common even without high parasite levels, indicating potential neurological impact.
Area of Science:
- Neurology
- Infectious Diseases
- Radiology
Background:
- Cerebral malaria is known to cause brain MRI abnormalities.
- Limited data exists on brain MRI findings in non-cerebral malaria patients.
Purpose of the Study:
- To determine the frequency of brain MRI findings in travelers with non-cerebral malaria.
- To correlate MRI findings with clinical data and parasite levels.
Main Methods:
- 17 inpatients with Plasmodium falciparum non-cerebral malaria underwent 3.0 Tesla structural brain MRI, including susceptibility-weighted imaging (SWI).
- Imaging findings were documented and statistically analyzed against clinical data and parasitemia.
Main Results:
- T2-hyperintense splenial lesions were observed in 3 patients, with 2 showing diffusion restriction.
- Brain microhemorrhages were detected in 3 patients.
- White matter T2-hyperintensities varied from absent to diffuse, with 2 patients showing over 50 lesions. No association was found between imaging findings and parasitemia or HRP2 levels.
Conclusions:
- Brain MRI reveals a significant frequency of T2-hyperintense splenial lesions in travelers with non-cerebral malaria.
- These splenial lesions appear to be independent of parasite levels in non-cerebral malaria.
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