患有脑型疟疾的非洲人的颅内高压
Intracranial hypertension in Africans with cerebral malaria.
作者信息
Newton C R, Crawley J, Sowumni A, Waruiru C, Mwangi I, English M, Murphy S, Winstanley P A, Marsh K, Kirkham F J
机构信息
Kenya Medical Research Institute, Clinical Research Centre, Kilifi, Kenya.
出版信息
Arch Dis Child. 1997 Mar;76(3):219-26. doi: 10.1136/adc.76.3.219.
The causes of death and neurological sequelae in African children with cerebral malaria are obscure. Intracranial pressure (ICP) was monitored and cerebral perfusion pressure (CPP) calculated in 23 Kenyan children with cerebral malaria. Four children had severe intracranial hypertension (ICP > 40 mm Hg, CPP < 40 mm Hg): two died, one with an ICP of 158 mm Hg and signs of transtentorial herniation, the other one with an ICP of 42 mm Hg and cardiorespiratory arrest. The other two survived with severe neurological sequelae. Nine had intermediate intracranial hypertension (ICP > 20 mm Hg, CPP < 50 mm Hg) and 10 had mild intracranial hypertension (maximum ICP 10-20 mm Hg); all survived without severe sequelae. Mannitol controlled the ICP in children with intermediate intracranial hypertension, but it did not prevent the development of intractable intracranial hypertension in children with severe intracranial hypertension. Intracranial hypertension is a feature of Kenyan children with cerebral malaria and severe intracranial hypertension is associated with a poor outcome.
非洲患脑型疟疾儿童的死亡原因及神经后遗症尚不明确。对23名肯尼亚脑型疟疾患儿进行了颅内压（ICP）监测并计算了脑灌注压（CPP）。4名儿童出现严重颅内高压（ICP>40 mmHg，CPP<40 mmHg）：2名死亡，1名ICP为158 mmHg且有小脑幕切迹疝体征，另1名ICP为42 mmHg且发生心搏呼吸骤停。另外2名存活但有严重神经后遗症。9名有中度颅内高压（ICP>20 mmHg，CPP<50 mmHg），10名有轻度颅内高压（最大ICP 10 - 20 mmHg）；所有患儿均存活且无严重后遗症。甘露醇可控制中度颅内高压患儿的ICP，但不能预防重度颅内高压患儿顽固性颅内高压的发生。颅内高压是肯尼亚脑型疟疾患儿的一个特征，严重颅内高压与不良预后相关。
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