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Lumbar punctures were performed in 40 Gambian children with acute cerebral malaria aged between 18 months and 10 years. The mean opening pressure was elevated in 32 (80%) of the children, but was not significantly different in the 14 fatal cases compared with survivors: 110 (standard deviation 71) versus 131 (58) mm of cerebrospinal fluid respectively. Cerebral perfusion pressures were also similar in the 2 groups: 64 (20) mm Hg versus 64 (11) mm Hg respectively. There was no clear clinical evidence of raised intracranial pressure, and no evidence of deterioration immediately following lumbar puncture. Nevertheless brain swelling, and consequent brain-stem compression, may contribute to a fatal outcome in cerebral malaria--particularly in those children who die from sudden respiratory arrest. A prospective evaluation of osmotic agents in childhood cerebral malaria seems to be justified.

Original publication

DOI

10.1016/0035-9203(91)90291-6

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

05/1991

Volume

85

Pages

362 - 364

Keywords

Child, Child, Preschool, Humans, Infant, Intracranial Pressure, Malaria, Cerebral, Prospective Studies, Spinal Puncture