Perturbations of cerebral hemodynamics in Kenyans with cerebral malaria.

Abstract:

:The mechanisms of death and neurologic sequelae in African children with cerebral malaria are undetermined. Because pathologic features are confined to the cerebral vasculature, perturbations in cerebral hemodynamics may be responsible. We compared the transcranial Doppler findings in 50 children with cerebral malaria with those of 115 conscious Kenyan children. In addition, 10 children with cerebral malaria were studied during intracranial pressure monitoring and nine children were studied during the agonal stages. In the children with cerebral malaria, cerebral blood flow velocity was increased in 30%, usually associated with seizures. Of the 11 children who developed neurologic sequelae, six had sonographic abnormalities associated with lateralizing deficits, including four children with hemiparesis (in two children the contralateral middle cerebral artery could not be insonated and two had transient increases in blood flow velocity associated with seizures). In the children with severe intracranial hypertension, there was a significant linear relationship between the cerebral perfusion pressure and blood flow velocity, suggesting that autoregulation was impaired. Sonographic features of progressive intracranial hypertension, were observed in three children with cerebral malaria who died. Perturbations of cerebral hemodynamics are associated with a poor outcome in Kenyan children with cerebral malaria.

journal_name

Pediatr Neurol

journal_title

Pediatric neurology

authors

Newton CR,Marsh K,Peshu N,Kirkham FJ

doi

10.1016/0887-8994(96)00115-4

subject

Has Abstract

pub_date

1996-07-01 00:00:00

pages

41-9

issue

1

eissn

0887-8994

issn

1873-5150

pii

0887899496001154

journal_volume

15

pub_type

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