Case Report: Reversible Cerebral Vasoconstriction Syndrome in Cerebral Malaria

Am J Trop Med Hyg. 2018 Feb;98(2):505-507. doi: 10.4269/ajtmh.17-0665. Epub 2017 Dec 14.

Abstract

Cerebral malaria is a severe complication of falciparum malaria that occurs infrequently in adults. Here, we describe the case of a 21-year-old man who presented with fever and headache 13 days after returning from a 12-day trip to Kenya and was subsequently diagnosed with falciparum malaria. Complications of cerebral malaria developed within 1 day after the initiation of therapy with intravenous quinine, and the patient entered a deep coma. Magnetic resonance angiography (MRA) revealed multiple vasoconstrictions in his brain. The resulting neurocognitive disorders that persisted after parasite clearance improved gradually, as confirmed by MRA, enabling the patient to perform activities of daily living upon discharge. In this case of cerebral malaria, the MRA findings indicated the involvement of reversible cerebral vasoconstriction syndrome.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / therapeutic use
  • Fever / etiology
  • Humans
  • Magnetic Resonance Angiography / methods
  • Malaria, Cerebral / diagnosis
  • Malaria, Cerebral / drug therapy*
  • Male
  • Pain / etiology
  • Quinine / therapeutic use
  • Vasoconstriction / drug effects*
  • Young Adult

Substances

  • Antimalarials
  • Quinine