Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome.
Cerebral malaria: mechanisms of brain injury and strategies for improved neurocognitive outcome.
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DOI：
10.1203/pdr.0b013e3181eee738
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发表时间：
2010-10
影响因子：
3.6
通讯作者：
Newton CR
中科院分区：
文献类型：
--
作者：
Idro R;Marsh K;John CC;Newton CR
脑型疟疾是恶性疟原虫感染后最严重的神经系统并发症。撒哈拉以南非洲地区的儿童受影响最大，每年有575 000多例。幸存的患者患神经和认知缺陷、行为困难和癫痫的风险增加，使脑型疟疾成为该地区儿童神经残疾的主要原因。神经认知后遗症的发病机制知之甚少：昏迷通过多种机制发展，可能有几种脑损伤机制。目前还不清楚血管内寄生虫是如何引起这种脑损伤的。了解这些机制对于制定适当的神经保护干预措施非常重要。本文探讨了脑型疟疾脑损伤的可能机制，将其与疾病的发病机制联系起来，并探讨了改善神经认知结果的前景。
Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum. With over 575,000 cases annually, children in sub-Saharan Africa are the most affected. Surviving patients have an increased risk of neurological and cognitive deficits, behavioral difficulties and epilepsy making cerebral malaria a leading cause of childhood neuro-disability in the region. The pathogenesis of neuro-cognitive sequelae is poorly understood: coma develops through multiple mechanisms and there may be several mechanisms of brain injury. It is unclear how an intravascular parasite causes such brain injury. Understanding these mechanisms is important to develop appropriate neuro-protective interventions. This paper examines possible mechanisms of brain injury in cerebral malaria, relating this to the pathogenesis of the disease and explores prospects for improved neuro-cognitive outcome.