- Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum malaria. Mortality is high and some surviving patients with sustained/INS; brain injury manifest as long-term neuro-cognitive impairments. Cerebral malaria is seen in 2% of malaria cases. In endemic areas it affects mainly children. Occurrence in adults is far less. Here we report a 27-year-old man with cerebral malaria who has a rare but suggestive radiologic finding for malaria. He has been admitted to our emergency department with fever, diarrho/INS;ea, muscle pain, headache and progressive drowsiness. He visited Sierra Leone, Africa 5 days ago. His physical /INS;examination revealed icterus, hepatosplenomegaly and dark urine. At his neurological examination, he was leth/INS;argic and had a score of 6 on the Glasgow Coma Scale. He has meningeal irritation signs with neck stiffness. Cranial MRI performed urgently and showed focal restricted diffusion in corpus callosum splenium in diffusion weighted imaging. Epileptic attacks have been observed and his EEG revealed generalised severe background slowing. Blood smears showed Plasmodium falciparum. Urgent antimalarial treatments have been administered/INS; /INS;and the patient regained consciousness. Antiepileptic medication was progressively reduced and the treatment was finally stopped after normal EEG was /INS;obtained. Awareness of clinical and radiological features of malaria and cerebral malaria is really important for early recognition and treatment. Taking the visiting history of an endemic area is helpful for diagnosis.
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