Acute Brain MRI Findings in 120 Malawian Children with Cerebral Malaria: New Insights into an Ancient Disease

Potchen, M. J., Kampondeni, S. D., Seydel, K. B., Birbeck, G. L., Hammond, C. A., Bradley, W. G., DeMarco, J. K., Glover, S. J., Ugorji, J. O., Latourette, M. T., Siebert, J. E., Molyneux, Malcolm E and Taylor, T. E. (2012) 'Acute Brain MRI Findings in 120 Malawian Children with Cerebral Malaria: New Insights into an Ancient Disease'. American Journal of Neuroradiology, Vol 33, Issue 9, pp. 1740-1746.

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Abstract

BACKGROUND AND PURPOSE: There have been few neuroimaging studies of pediatric CM, a common often fatal tropical condition. We undertook a prospective study of pediatric CM to better characterize the MRI features of this syndrome, comparing findings in children meeting a stringent definition of CM with those in a control group who were infected with malaria but who were likely to have a nonmalarial cause of coma.

MATERIALS AND METHODS: Consecutive children admitted with traditionally defined CM (parasitemia, coma, and no other coma etiology evident) were eligible for this study. The presence or absence of malaria retinopathy was determined. MRI findings in children with ret+ CM (patients) were compared with those with ret− CM (controls). Two radiologists blinded to retinopathy status jointly developed a scoring procedure for image interpretation and provided independent reviews. MRI findings were compared between patients with and without retinopathy, to assess the specificity of changes for patients with very strictly defined CM.

RESULTS: Of 152 children with clinically defined CM, 120 were ret+, and 32 were ret−. Abnormalities much more common in the patients with ret+ CM were markedly increased brain volume; abnormal T2 signal intensity; and DWI abnormalities in the cortical, deep gray, and white matter structures. Focal abnormalities rarely respected arterial vascular distributions. Most of the findings in the more clinically heterogeneous ret− group were normal, and none of the abnormalities noted were more prevalent in controls.

CONCLUSIONS: Distinctive MRI findings present in patients meeting a stringent definition of CM may offer insights into disease pathogenesis and treatment.

Item Type:	Article
Subjects:	WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WL Nervous System > WL 300 General works (Include works on brain alone) WN Radiology. Diagnostic imaging > WN 185 Magnetic resonance imaging WS Pediatrics > Diseases of Children and Adolescents > By System > WS 340 Nervous system
Faculty: Department:	Groups (2002 - 2012) > Clinical Group
Digital Object Identifer (DOI):	https://doi.org/10.3174/ajnr.A3035
Depositing User:	Martin Chapman
Date Deposited:	18 Dec 2014 16:29
Last Modified:	17 Aug 2022 08:57
URI:	https://archive.lstmed.ac.uk/id/eprint/4694

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