Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan.
Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.
Am J Trop Med Hyg. 2018 Feb;98(2):505-507. doi: 10.4269/ajtmh.17-0665. Epub 2017 Dec 14.
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.
脑型疟疾是恶性疟原虫疟疾的一种严重并发症，在成人中不常见。在这里，我们描述了一例 21 岁男性的病例，他在从肯尼亚旅行 12 天后出现发热和头痛，随后被诊断为恶性疟原虫疟疾。在静脉注射奎宁开始治疗后 1 天内，出现脑型疟疾并发症，患者进入深度昏迷。磁共振血管造影（MRA）显示他的大脑中有多处血管收缩。寄生虫清除后，神经认知障碍持续存在，MRA 证实了这一点，患者在出院时能够进行日常生活活动。在这种脑型疟疾中，MRA 结果表明存在可逆性脑动脉收缩综合征。
