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Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum. With >575,000 cases annually, children in sub-Saharan Africa are the most affected. Surviving patients have an increased risk of neurological and cognitive deficits, behavioral difficulties, and epilepsy making cerebral malaria a leading cause of childhood neurodisability in the region. The pathogenesis of neurocognitive sequelae is poorly understood: coma develops through multiple mechanisms and there may be several mechanisms of brain injury. It is unclear how an intravascular parasite causes such brain injury. Understanding these mechanisms is important to develop appropriate neuroprotective interventions. This article examines possible mechanisms of brain injury in cerebral malaria, relating this to the pathogenesis of the disease, and explores prospects for improved neurocognitive outcome.

Original publication

DOI

10.1203/PDR.0b013e3181eee738

Type

Journal article

Journal

Pediatr Res

Publication Date

10/2010

Volume

68

Pages

267 - 274

Keywords

Antimalarials, Brain Diseases, Child, Child Behavior, Child, Preschool, Cognition, Coma, Epilepsy, Humans, Language Disorders, Malaria, Cerebral, Motor Activity, Movement Disorders, Neuroprotective Agents, Plasmodium falciparum, Recovery of Function, Speech Disorders, Time Factors, Treatment Outcome