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Volume 8 Issue 5 (May, 2020)

Original Articles

Incidence of hemorrhagical manifestations in cerebral malaria patients
Dr. Avesh, Dr. Jayanti Singh, Dr. R N Singh

Background: Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum malaria. It is a clinical syndrome characterized by coma and asexual forms of the parasite on peripheral blood smears. Mortality is high and some surviving patients sustain brain injury which manifest as long-term neuro-cognitive impairments. The mechanisms of neural injury in cerebral malaria are poorly understood. Although the pathogenesis of cerebral malaria is also incompletely understood, an insight into it can provide leads to the mechanisms of brain injury. Aim of the study: To evaluate the incidence of hemorrhagical manifestations in cerebral malaria patients. Materials and methods: The study was conducted in the Department of General Medicine of the Medical institute. For the study, 60 patients admitted to the medical ward with symptoms of cerebral malaria were included in our study. Patients below 12 years, pregnant women, patients unfit for MRI and those having other systemic conditions such as diabetes, leukemia were excluded from the study. After obtaining an informed consent, all patients were subjected to a preoperative work up. Majority of patients had brief episodes of loss of consciousness and few episodes of focal seizures that responded to anticonvulsants. All the patients were subjected to anti-malarial treatment along with supportive treatment. Results: A total of 60 patients were included in the study. The number of male patients in the study was 34 and number of female patients was 26. The mean age of the patients was 35.72 years. In total 20 patients were diagnosed from the MRI having cerebral hemorrhagic infarct. The basal ganglia infarct was seen in 5 patients, thalamus infarct in 6 patients, cerebellum infarct in 3 patients, pontine infarct in one patient, parietal occipital lobe infarct in 4 patients and other findings were seen in 1 patient. Conclusion: Within the limitations of the study we conclude that patients with cerebral malaria are at high risk for cerebral hemorrhage and MRI should be conducted for each patient for diagnosis at early stage. Keywords: Cerebral malaria, cerebral infarct, MRI brain

 
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