MRI Findings in a Cohort of Brain Injured Survivors of Pediatric Cerebral Malaria
MRI Findings in a Cohort of Brain Injured Survivors of Pediatric Cerebral Malaria
复制标题
DOI:
10.4269/ajtmh.12-0538
复制
发表时间:
2013-03-01
影响因子:
3.3
通讯作者:
Birbeck, Gretchen L.
中科院分区:
文献类型:
--
作者:
Kampondeni, Sam D.;Potchen, Michael J.;Birbeck, Gretchen L.
A prospective cohort study of retinopathy-confirmed cerebral malaria (CM) survivors identified 42 of 132 with neurologic sequelae. The 38 survivors with sequelae who were alive when magnetic resonance imaging (MRI) technology became available underwent brain MRIs. Common MRI abnormalities included periventricular T2 signal changes (53%), atrophy (47%), subcortical T2 signal changes (18%), and focal cortical defects (16%). The chi(2) tests assessed the relationship between chronic MRI findings, acute clinical and demographic data, and outcomes. Children who were older at the time of CM infection (P = 0.01) and those with isolated behavioral problems (P = 0.02) were more likely to have a normal MRI. Acute focal seizures were associated with atrophy (P = 0.05). Acute papilledema was associated with subcortical T2 signal changes (P = 0.02). Peripheral retinal whitening (P = 0.007) and a higher admission white blood cell count (P = 0.02) were associated with periventricular T2 signal changes. Chronic MRI findings suggest seizures, increased intracranial pressure, and microvascular ischemia contribute to clinically relevant structural brain injury in CM.