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Adult Cerebral Malaria: Acute and Subacute Imaging Findings, Long-term Clinical Consequences

Charles Coughlan1, Hans Rolf Jäger2,3,4, David Brealey5

  • 1Department of Infectious Diseses, University College London Hospitals NHS Foundation Trust, London, United Kingdom.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|October 28, 2023
PubMed

Insights

Cerebral malaria can cause death and long-term brain damage. This study reveals specific MRI findings, including brain swelling and bleeding, in patients with cerebral malaria, linking these to lasting disabilities.

Area of Science:

  • Neurology
  • Radiology
  • Infectious Diseases

Background:

  • Cerebral malaria is a severe complication of Plasmodium falciparum infection.
  • It is a leading cause of mortality and neurological deficits in endemic areas.
  • Understanding its neuroimaging features is crucial for diagnosis and management.

Purpose of the Study:

  • To describe the magnetic resonance imaging (MRI) findings in two adult cases of cerebral malaria in the UK.
  • To compare these findings with those in a cohort of Indian patients.
  • To correlate long-term imaging changes with residual functional impairment.

Main Methods:

  • Retrospective analysis of MRI scans from two adult UK cerebral malaria cases.
  • Comparison with MRI data from a cohort of Indian cerebral malaria patients.
  • Longitudinal follow-up imaging and clinical assessment.

Main Results:

  • MRI revealed cytotoxic and vasogenic cerebral edema.
  • Microhemorrhages were observed in the affected brains.
  • UK and Indian cohorts showed comparable imaging patterns.
  • Follow-up imaging correlated with persistent neurological deficits.

Conclusions:

  • Specific MRI features, including edema and microhemorrhages, characterize cerebral malaria.
  • Neuroimaging findings can predict long-term functional outcomes.
  • Further research is needed to elucidate the pathophysiology and improve treatment strategies.
Keywords:
MRIcerebral malariamalarianeuro-disabilityneuro-imaging

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