title: Transient lesion in the splenium of the corpus callosum in acute uncomplicated falciparum malaria.
abstract: Patients with acute uncomplicated Plasmodium falciparum malaria have no evident neurologic disorder, vital organ dysfunction, or other severe manifestations of infection. Nonetheless, parasitized erythrocytes cytoadhere to the endothelium throughout their microvasculature, especially within the brain. We aimed to determine if 3 Tesla magnetic resonance imaging studies could detect evidence of cerebral abnormalities in these patients. Within 24 hours of admission, initial magnetic resonance imaging examinations found a lesion with restricted water diffusion in the mid-portion of the splenium of the corpus callosum of 4 (40%) of 10 male patients. The four patients who had a splenial lesion initially had evidence of more severe hemolysis and thrombocytopenia than the six patients who had no apparent abnormality. Repeat studies four weeks later found no residua of the lesions and resolution of the hematologic differences. These observations provide evidence for acute cerebral injury in the absence of severe or cerebral malaria.
authors.forename: Jiraporn
authors.initials: J
authors.lastname: Laothamatas
authors.forename: Christina L
authors.initials: CL
authors.lastname: Sammet
authors.forename: Xavier
authors.initials: X
authors.lastname: Golay
authors.forename: Marc
authors.initials: M
authors.lastname: Van Cauteren
authors.forename: Varinee
authors.initials: V
authors.lastname: Lekprasert
authors.forename: Noppadon
authors.initials: N
authors.lastname: Tangpukdee
authors.forename: Srivicha
authors.initials: S
authors.lastname: Krudsood
authors.forename: Wattana
authors.initials: W
authors.lastname: Leowattana
authors.forename: Polrat
authors.initials: P
authors.lastname: Wilairatana
authors.forename: Srirama V
authors.initials: SV
authors.lastname: Swaminathan
authors.forename: Robert L
authors.initials: RL
authors.lastname: DeLaPaz
authors.forename: Truman R
authors.initials: TR
authors.lastname: Brown
authors.forename: Sornchai
authors.initials: S
authors.lastname: Looareesuwan
authors.forename: Gary M
authors.initials: GM
authors.lastname: Brittenham
mesh_terms: D000208:Acute Disease; D000328:Adult; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage; D002738:Chloroquine / Q000008:administration & dosage; D003337:Corpus Callosum / Q000469:parasitology / Q000473:pathology*; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006461:Hemolysis; D006801:Humans; D008279:Magnetic Resonance Imaging; D016778:Malaria, Falciparum / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D018512:Parasitemia; D011319:Primaquine / Q000008:administration & dosage; D011446:Prospective Studies; D011859:Radiography; D013785:Thailand; D013921:Thrombocytopenia; D055815:Young Adult
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D002738:Chloroquine; D011319:Primaquine