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Hemiparesis post cerebral malaria.

Taiaa O, Amil T, Darbi A - Pan Afr Med J (2015)

Bottom Line: In endemic areas, the cerebral malaria interested mainly children.The occurrence in adults is very rare and most interested adult traveling in tropical zones.This complication has been reported especially in children and seems very rare in adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Hospital Mohamed V Instruction, Rabat, Morocco.

ABSTRACT
Cerebral malaria is one of the most serious complications in the Plasmodium falciparum infection. In endemic areas, the cerebral malaria interested mainly children. The occurrence in adults is very rare and most interested adult traveling in tropical zones. This case report describes a motor deficit post cerebral malaria in a young adult traveling in malaria endemic area. This complication has been reported especially in children and seems very rare in adults.

No MeSH data available.


Related in: MedlinePlus

(A, B, C) white matter changes. The first examination, 3 days after the onset of cerebral malaria, shows diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum; (D) with central microhemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence
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Figure 0001: (A, B, C) white matter changes. The first examination, 3 days after the onset of cerebral malaria, shows diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum; (D) with central microhemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence

Mentions: A 32-year-old Moroccan traveling in the Democratic Republic of Congo for five month, had neglected his malaria chemoprophylaxis. He developed fever, confusion and became rapidly comatose. So he was transferred to Morocco. At neurologic examination, Glasgow Coma Scale (GCS) was at 7, and he experienced in the emergency department an episode of tonic-clonic seizures lasting 30 seconds that was controlled by phenytoin administration. Plasmodium falciparum was seen on the blood smear. Other complications of malaria included acute renal failure, hepatic failure and retinopathy was determined. The patient was placed on mechanical ventilation. Specific treatment was started with intravenous doxycycline and quinine dihydrochloride. A brain CT on the first day was normal. A first brain magnetic resonance imaging (MRI), on day 3, performed on a 1.5-T unit included sagittal and axial 5-mm-thick T1-weighted images, axial 4-mm-thick T2-weighted images, susceptibility-weighted imaging(SWI), Gradient Echo (T2*) sequence, axial 4-mm-thick T1-weighted images, before and after contrast injection, and axial fluid-attenuated inversion-recovery (FLAIR) sequences. The MRI showed diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum (Figure 1A, B, C) with central micro hemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence (Figure 1D). There was no enhancement on T1-weighted images. There was also no evidence for dural sinus thrombosis.


Hemiparesis post cerebral malaria.

Taiaa O, Amil T, Darbi A - Pan Afr Med J (2015)

(A, B, C) white matter changes. The first examination, 3 days after the onset of cerebral malaria, shows diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum; (D) with central microhemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4430154&req=5

Figure 0001: (A, B, C) white matter changes. The first examination, 3 days after the onset of cerebral malaria, shows diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum; (D) with central microhemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence
Mentions: A 32-year-old Moroccan traveling in the Democratic Republic of Congo for five month, had neglected his malaria chemoprophylaxis. He developed fever, confusion and became rapidly comatose. So he was transferred to Morocco. At neurologic examination, Glasgow Coma Scale (GCS) was at 7, and he experienced in the emergency department an episode of tonic-clonic seizures lasting 30 seconds that was controlled by phenytoin administration. Plasmodium falciparum was seen on the blood smear. Other complications of malaria included acute renal failure, hepatic failure and retinopathy was determined. The patient was placed on mechanical ventilation. Specific treatment was started with intravenous doxycycline and quinine dihydrochloride. A brain CT on the first day was normal. A first brain magnetic resonance imaging (MRI), on day 3, performed on a 1.5-T unit included sagittal and axial 5-mm-thick T1-weighted images, axial 4-mm-thick T2-weighted images, susceptibility-weighted imaging(SWI), Gradient Echo (T2*) sequence, axial 4-mm-thick T1-weighted images, before and after contrast injection, and axial fluid-attenuated inversion-recovery (FLAIR) sequences. The MRI showed diffuses hyperintensities on T2, T2- FLAIR-weighted and the SWI sequences images in the centrum semiovale, periventricular, frontal and occipital white matter, and in the cerebellum (Figure 1A, B, C) with central micro hemorrhages in the occipital, frontal and right semiovale centrum white matter lesions on Gradient Echo (T2*) sequence (Figure 1D). There was no enhancement on T1-weighted images. There was also no evidence for dural sinus thrombosis.

Bottom Line: In endemic areas, the cerebral malaria interested mainly children.The occurrence in adults is very rare and most interested adult traveling in tropical zones.This complication has been reported especially in children and seems very rare in adults.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Military Hospital Mohamed V Instruction, Rabat, Morocco.

ABSTRACT
Cerebral malaria is one of the most serious complications in the Plasmodium falciparum infection. In endemic areas, the cerebral malaria interested mainly children. The occurrence in adults is very rare and most interested adult traveling in tropical zones. This case report describes a motor deficit post cerebral malaria in a young adult traveling in malaria endemic area. This complication has been reported especially in children and seems very rare in adults.

No MeSH data available.


Related in: MedlinePlus