Cerebral malaria is a variant on malaria characterized by encephalopathy, where the brain becomes involved. The precise causes are poorly understood, and researchers do not understand why some malaria patients develop cerebral malaria and others do not. Children tend to be more at risk, and if it is not treated, it will be fatal within a matter of days. Treatment requires aggressive antimalarial drugs, along with supportive care, to address complications of cerebral malaria.
Two different theories have been put forward to explain the pathology of cerebral malaria. Some physicians believe that infected red blood cells begin adhering to the walls of the blood vessels supplying the brain, causing localized ischemia, where blood fails to reach certain areas of the brain. This causes brain damage and a cascading series of symptoms. Others think cerebral malaria may be caused by the release of toxins from the malaria parasites, setting off a reaction in the brain.
Patients with cerebral malaria develop a high fever and altered level of consciousness, slipping eventually into a coma. In the early stages, the patient can be roused but will stop responding as the damage to the brain spreads. Patients usually experience seizures. With treatment, recovery rates vary, and some patients have lingering neurological problems like ataxia, an imbalanced gait caused by damage to the motor areas of the brain.
This condition may involve drug-resistant parasites that resisted earlier attempts at treatment for a malaria infection. Patients need access to aggressive drugs and must be treated promptly. While in treatment, they are also monitored for respiratory problems, kidney failure, and other complications of cerebral malaria. These complications occur as areas of the brain involved in bodily functions are damaged by the infection.
Concern about malaria in general and this variant of it in particular has led to the introduction of a number of malaria elimination programs in various regions of the world. These programs use measures like prophylactic medication, insect elimination campaigns, and provision of sleeping nets to provide people with some protections against this tropical parasite. The increased risks to children with this infection are a special cause for concern, and children also tend to be more likely to experience lingering side effects like neurological deficits. Addressing malaria in children is complicated by issues like lack of access to affordable medications, limited education, and the remoteness of many areas where malaria is present, making it hard to provide medical outreach services.
