A Prospective Study of Magnetic Resonance Imaging of Brain in Cerebral Malaria in Children

Background and Objectives: Cerebral malaria (CM) is the leading cause of seizures and encephalopathy and a major cause of death in the pediatric age group. Our objective was to look for magnetic resonance imaging (MRI) changes in CM and to correlate the findings with clinical parameters and outcome. Materials and Methods: This cross-sectional study was conducted over a period of 2 years in the pediatrics department of a tertiary care teaching hospital, Western India. Children suffering from CM (as defined by the World Health Organization) during the study period were subjected to MRI study of brain. All the data were analyzed with appropriate statistical methods. Results: Twenty cases were included. The mean age was 8.5 (±3.52) years, with males being 75%. Headache and vomiting were the presenting symptoms (30% each), and the most common signs were pallor and seizure. The mean duration of altered sensorium was 18.55 (±11.19) h, and the mean coma recovery time was 14.65 (±6.8) h. Retinal hemorrhages were present in 40%. The study did not find any statistical significance between MRI finding and Glasgow Coma Scale level. None of the MRI findings revealed any significant association with parasitemia. No significant association was found between focal, diffuse swelling of brain and restricted diffusion in the MRI brain with the outcome. Conclusions: In children with CM, MRI findings did not correlate with clinical parameters and outcomes. All the MRI abnormalities disappeared within a short period. Further studies with larger sample size are needed to support or refute the present study findings.