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Brain swelling and ischaemia in Kenyans with cerebral malaria

Brain swelling and ischaemia in Kenyans with cerebral malaria
Brain swelling and ischaemia in Kenyans with cerebral malaria

Computed tomography was performed on 14 unconscious Kenyan children recovering from cerebral malaria (seven ofwhom had another scan 12-120 days later) to elucidate the cause of intracranial hypertension and neurological sequelae. Brain swelling, defined as a loss of cerebrospinal fluid spaces, was documented in six children, while a further two had conspicuously small ventricles only. There was severe intracranial hypertension in the two children with definite brain swelling in whom intracranial pressure was monitored. There was no evidence of acute hydrocephalus or vasogenic oedema. Four children with brain swelling also had widespread low density areas suggestive of ischaemic damage. The patterns of damage were not uniform but were consistent with a critical reduction in cerebral perfusion pressure (which was documented in the two in whom this was monitored), hypoglycaemia, or status epilepticus. All four had serious neurological sequelae. These data suggest that brain injury in cerebral malaria may be due in part to secondary systemic and intracranial factors as well as to the direct effect of intravascular sequestration.

0003-9888
281-287
Newton, C.R.J.C.
69823ac2-7013-48db-b97c-86ab1d00b6ed
Peshu, N.
5abe6b16-8d5d-4c0e-b81d-948659635b6f
Kendall, B.
f3bcbbb3-8fdd-4638-b9ff-3d946ebe178c
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Sowunmi, A.
a75d990c-464a-40b5-b0d4-4af7009a9731
Waruiru, C.
b561024b-6cfd-4285-a49a-fdc09f17064e
Mwangi, I.
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Murphy, S.A.
898d000c-ef0a-4abd-bd9c-f8c885b01055
Marsh, K.
95e94ebd-5093-4199-acc3-687945eefb1e
Newton, C.R.J.C.
69823ac2-7013-48db-b97c-86ab1d00b6ed
Peshu, N.
5abe6b16-8d5d-4c0e-b81d-948659635b6f
Kendall, B.
f3bcbbb3-8fdd-4638-b9ff-3d946ebe178c
Kirkham, F.J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Sowunmi, A.
a75d990c-464a-40b5-b0d4-4af7009a9731
Waruiru, C.
b561024b-6cfd-4285-a49a-fdc09f17064e
Mwangi, I.
2e3d6e3c-c1ee-4263-8a77-2fb070a3a870
Murphy, S.A.
898d000c-ef0a-4abd-bd9c-f8c885b01055
Marsh, K.
95e94ebd-5093-4199-acc3-687945eefb1e

Newton, C.R.J.C., Peshu, N., Kendall, B., Kirkham, F.J., Sowunmi, A., Waruiru, C., Mwangi, I., Murphy, S.A. and Marsh, K. (1994) Brain swelling and ischaemia in Kenyans with cerebral malaria. Archives of Disease in Childhood, 70 (4), 281-287. (doi:10.1136/adc.70.4.281).

Record type: Article

Abstract

Computed tomography was performed on 14 unconscious Kenyan children recovering from cerebral malaria (seven ofwhom had another scan 12-120 days later) to elucidate the cause of intracranial hypertension and neurological sequelae. Brain swelling, defined as a loss of cerebrospinal fluid spaces, was documented in six children, while a further two had conspicuously small ventricles only. There was severe intracranial hypertension in the two children with definite brain swelling in whom intracranial pressure was monitored. There was no evidence of acute hydrocephalus or vasogenic oedema. Four children with brain swelling also had widespread low density areas suggestive of ischaemic damage. The patterns of damage were not uniform but were consistent with a critical reduction in cerebral perfusion pressure (which was documented in the two in whom this was monitored), hypoglycaemia, or status epilepticus. All four had serious neurological sequelae. These data suggest that brain injury in cerebral malaria may be due in part to secondary systemic and intracranial factors as well as to the direct effect of intravascular sequestration.

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Published date: April 1994

Identifiers

Local EPrints ID: 429786
URI: https://eprints.soton.ac.uk/id/eprint/429786
ISSN: 0003-9888
PURE UUID: 624e1e9b-54ae-4680-b8bb-1c290f535f7a
ORCID for F.J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 05 Apr 2019 16:30
Last modified: 13 Jun 2019 00:37

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Contributors

Author: C.R.J.C. Newton
Author: N. Peshu
Author: B. Kendall
Author: F.J. Kirkham ORCID iD
Author: A. Sowunmi
Author: C. Waruiru
Author: I. Mwangi
Author: S.A. Murphy
Author: K. Marsh

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