Observational studyMalaria journal2014
Magnetic resonance imaging of the brain in adults with severe falciparum malaria.
Observational study in Malaria journal, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers.
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Who cites it
37 citing papers in PubMed, 59 citations in OpenAlex.
- Mini-review and situation report on the role and usefulness of nuclear medicine imaging for malaria.European journal of nuclear medicine and molecular imaging · 2026Review
- Radiological findings in fulminant cerebral malaria: a rare neuroimaging presentation.Malaria journal · 2025Article
- Cerebral manifestations of falciparum malaria in adults: more than meets the eye.Trends in parasitology · 2025Review
- Article
- Contribution of Magnetic Resonance Imaging Studies to the Understanding of Cerebral Malaria Pathogenesis.Pathogens (Basel, Switzerland) · 2024Review
- Sudden Onset of Coma and Fulminant Progression to Brain Death in a 48-Year-Old Male With Cerebral Malaria.Case reports in critical care · 2024Article
- Pathogenetic mechanisms and treatment targets in cerebral malaria.Nature reviews. Neurology · 2023Review
- Diagnosis of cerebral malaria: Tools to reduceFrontiers in cellular and infection microbiology · 2023Review
- Cerebral Malaria and Neuronal Implications of Plasmodium Falciparum Infection: From Mechanisms to Advanced Models.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2022Review
- Advances in Basic and Translational Research as Part of the Center for the Study of Complex Malaria in India.The American journal of tropical medicine and hygiene · 2022Article
- Evidence of Brain Alterations in Noncerebral Falciparum Malaria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Article
- Brain Magnetic Resonance Imaging Reveals Different Courses of Disease in Pediatric and Adult Cerebral Malaria.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021Article
- Transcriptome-based analysis of blood samples reveals elevation of DNA damage response, neutrophil degranulation, cancer and neurodegenerative pathways in Plasmodium falciparum patients.Malaria journal · 2021Article
- Determinants of brain swelling in pediatric and adult cerebral malaria.JCI insight · 2021Article
- Immune system challenge improves recognition memory and reverses malaria-induced cognitive impairment in mice.Scientific reports · 2021Article
- Plasma angiopoietin-2 is associated with age-related deficits in cognitive sub-scales in Ugandan children following severe malaria.Malaria journal · 2021Article
- Harnessing the Potential of miRNAs in Malaria Diagnostic and Prevention.Frontiers in cellular and infection microbiology · 2021Review
- Aberrant Dopamine Receptor Signaling Plays Critical Role in the Impairment of Striatal Neurons in Experimental Cerebral Malaria.Molecular neurobiology · 2020Article
- Molecular Imaging of a Zirconium-89 Labeled Antibody Targeting Plasmodium falciparum-Infected Human Erythrocytes.Molecular imaging and biology · 2020Article
- Lung endothelial cell antigen cross-presentation to CD8Nature communications · 2019Article
Corrections and comments
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Authors and funding
17 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundMagnetic resonance imaging (MRI) allows detailed study of structural and functional changes in the brain in patients with cerebral malaria.
methodsIn a prospective observational study in adult Bangladeshi patients with severe falciparum malaria, MRI findings in the brain were correlated with clinical and laboratory parameters, retinal photography and optic nerve sheath diameter (ONSD) ultrasound (a marker of intracranial pressure).
resultsOf 43 enrolled patients, 31 (72%) had coma and 12 (28%) died. MRI abnormalities were present in 79% overall with mostly mild changes in a wide range of anatomical sites. There were no differences in MRI findings between patients with cerebral and non-cerebral or fatal and non-fatal disease. Subtle diffuse cerebral swelling was common (n = 22/43), but mostly without vasogenic oedema or raised intracranial pressure (ONSD). Also seen were focal extracellular oedema (n = 11/43), cytotoxic oedema (n = 8/23) and mildly raised brain lactate on magnetic resonance spectroscopy (n = 5/14). Abnormalities were much less prominent than previously described in Malawian children. Retinal whitening was present in 36/43 (84%) patients and was more common and severe in patients with coma.
conclusionCerebral swelling is mild and not specific to coma or death in adult severe falciparum malaria. This differs markedly from African children. Retinal whitening, reflecting heterogeneous obstruction of the central nervous system microcirculation by sequestered parasites resulting in small patches of ischemia, is associated with coma and this process is likely important in the pathogenesis.
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