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Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria

Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria
Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria

The mechanisms of death and neurologic sequelae in African children with cerebral malaria are undetermined. Because pathologic features are confined to the cerebral vasculature, perturbations in cerebral hemodynamics may be responsible. We compared the transcranial Doppler findings in 50 children with cerebral malaria with those of 115 conscious Kenyan children. In addition, 10 children with cerebral malaria were studied during intracranial pressure monitoring and nine children were studied during the agonal stages. In the children with cerebral malaria, cerebral blood flow velocity was increased in 30%, usually associated with seizures. Of the 11 children who developed neurologic sequelae, six had sonographic abnormalities associated with lateralizing deficits, including four children with hemiparesis (in two children the contralateral middle cerebral artery could not be insonated and two had transient increases in blood flow velocity associated with seizures). In the children with severe intracranial hypertension, there was a significant linear relationship between the cerebral perfusion pressure and blood flow velocity, suggesting that autoregulation was impaired. Sonographic features of progressive intracranial hypertension, were observed in three children with cerebral malaria who died. Perturbations of cerebral hemodynamics are associated with a poor outcome in Kenyan children with cerebral malaria.

0887-8994
41-49
Newton, Charles R.J.C.
277959ee-d0c5-48c0-b624-1ef2676efef1
Marsh, Kevin
bb099cd9-3a89-44c7-9814-9ba04ae0689b
Peshu, Norbert
eebd2c62-26cc-4251-b52d-f4238f668cab
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58
Newton, Charles R.J.C.
277959ee-d0c5-48c0-b624-1ef2676efef1
Marsh, Kevin
bb099cd9-3a89-44c7-9814-9ba04ae0689b
Peshu, Norbert
eebd2c62-26cc-4251-b52d-f4238f668cab
Kirkham, Fenella J.
1dfbc0d5-aebe-4439-9fb2-dac6503bcd58

Newton, Charles R.J.C., Marsh, Kevin, Peshu, Norbert and Kirkham, Fenella J. (1996) Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria. Pediatric Neurology, 15 (1), 41-49. (doi:10.1016/0887-8994(96)00115-4).

Record type: Article

Abstract

The mechanisms of death and neurologic sequelae in African children with cerebral malaria are undetermined. Because pathologic features are confined to the cerebral vasculature, perturbations in cerebral hemodynamics may be responsible. We compared the transcranial Doppler findings in 50 children with cerebral malaria with those of 115 conscious Kenyan children. In addition, 10 children with cerebral malaria were studied during intracranial pressure monitoring and nine children were studied during the agonal stages. In the children with cerebral malaria, cerebral blood flow velocity was increased in 30%, usually associated with seizures. Of the 11 children who developed neurologic sequelae, six had sonographic abnormalities associated with lateralizing deficits, including four children with hemiparesis (in two children the contralateral middle cerebral artery could not be insonated and two had transient increases in blood flow velocity associated with seizures). In the children with severe intracranial hypertension, there was a significant linear relationship between the cerebral perfusion pressure and blood flow velocity, suggesting that autoregulation was impaired. Sonographic features of progressive intracranial hypertension, were observed in three children with cerebral malaria who died. Perturbations of cerebral hemodynamics are associated with a poor outcome in Kenyan children with cerebral malaria.

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Published date: July 1996

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Local EPrints ID: 429789
URI: https://eprints.soton.ac.uk/id/eprint/429789
ISSN: 0887-8994
PURE UUID: ac718251-dd91-47b3-9c45-b0e9630971fb
ORCID for Fenella J. Kirkham: ORCID iD orcid.org/0000-0002-2443-7958

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Date deposited: 05 Apr 2019 16:30
Last modified: 12 Nov 2019 01:51

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Contributors

Author: Charles R.J.C. Newton
Author: Kevin Marsh
Author: Norbert Peshu
Author: Fenella J. Kirkham ORCID iD

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