Coma in Fatal Adult Human Malaria and Its Relation to Cerebral Oedema
Author Information
Author(s): Medana Isabelle M, Day Nicholas PJ, Sachanonta Navakanit, Mai Nguyen TH, Dondorp Arjen M, Pongponratn Emsri, Hien Tran T, White Nicholas J, Turner Gareth D
Primary Institution: Nuffield Department of Clinical Laboratory Sciences, The John Radcliffe Hospital, University of Oxford, Oxford, UK
Hypothesis
The study aims to determine whether cerebral oedema is a major cause of coma in adults with fatal falciparum malaria.
Conclusion
Histological evidence of cerebral oedema did not correlate with the occurrence of pre-mortem coma in adults with fatal falciparum malaria.
Supporting Evidence
- Histological evidence of cerebral oedema was common in fatal cases of both cerebral and non-cerebral malaria.
- Different microscopic patterns of oedema were identified, but these did not correlate with pre-mortem coma.
- Enhanced expression of AQP4 water channels in the brainstem may reflect neuroprotective responses.
Takeaway
The study looked at the brains of people who died from severe malaria and found that swelling in the brain didn't always mean they were in a coma before they died.
Methodology
The brains of 20 adult patients who died of severe malaria were examined using histology, immunohistochemistry, and image analysis to assess vascular integrity and patterns of oedema.
Potential Biases
Potential biases may arise from the selection of cases and the interpretation of histological findings.
Limitations
The study is based on post-mortem analysis, which may not capture the dynamic processes occurring during the disease.
Participant Demographics
Adult Vietnamese patients who died of severe malaria.
Statistical Information
P-Value
.02
Confidence Interval
95% CI not specified
Statistical Significance
p = .02
Digital Object Identifier (DOI)
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