Intracranial pressure in African children with cerebral malaria.
Opening lumbar cerebrospinal fluid (CSF) pressure was measured with a paediatric spinal fluid manometer in 26 of 61 Kenyan children (mean age 39 months) with cerebral malaria. In all cases pressure was above normal (mean [SD]22.6 [7.4] cm CSF, range 10.5-36). Clinical features of our patients suggest that intracranial hypertension is important in the pathogenesis of cerebral malaria in children, especially as a cause of death. We suggest that raised intracranial pressure is secondary to increased cerebral blood volume. Lowering intracranial pressure may significantly reduce the mortality and morbidity of cerebral malaria. The potential risks and benefits of lumbar puncture should be considered carefully in patients with suspected cerebral malaria.
Newton
C R
CR
Kenya Medical Research Institute, Kilifi Coastal Unit.
Kirkham
F J
FJ
Winstanley
P A
PA
Pasvol
G
G
Peshu
N
N
Warrell
D A
DA
Marsh
K
K
D000818:Animals; D001927:Brain Diseases / Q000134:cerebrospinal fluid / Q000401:mortality / Q000469:parasitology / Q000503:physiopathology*; D001933:Brain Stem; D002423:Cause of Death; D002526:Cerebellar Diseases / Q000134:cerebrospinal fluid / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D002675:Child, Preschool; D003128:Coma / Q000134:cerebrospinal fluid / Q000401:mortality / Q000503:physiopathology*; D004677:Encephalocele / Q000134:cerebrospinal fluid / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D005069:Evaluation Studies as Topic; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008288:Malaria / Q000134:cerebrospinal fluid / Q000401:mortality / Q000469:parasitology / Q000503:physiopathology*; D008365:Manometry; D010963:Plasmodium falciparum; D011559:Pseudotumor Cerebri / Q000134:cerebrospinal fluid / Q000401:mortality / Q000469:parasitology / Q000503:physiopathology*; D012189:Retrospective Studies; D013129:Spinal Puncture / Q000009:adverse effects