Cerebral malaria

This chapter discusses diagnosis, clinical features, management, prognosis, and antimalarial chemotherapy of cerebral malaria. In cerebral malaria, mild hyponatremia and hypocholeremia are common. The blood urea is often elevated because of dehydration, but some degree of renal impairment is common. Abnormal liver function tests are also common, but difficult to interpret because of the coexisting hemolysis and release of muscle enzymes. The alanine aminotransferase value is usually proportionately lower than the corresponding aspartate aminotransferase or lactate dehydrogenase values, and the alkaline. The essentials of management are prompt administration of effective schizonticidal antimalarial drugs, intensive care of the unconscious patient and early detection or, where possible, avoidance of life-threatening complications, such as acute pulmonary edema, metabolic acidosis, renal failure, bacterial septicemia and aspiration pneumonia. If the clinical presentation and background are suggestive of cerebral malaria, then after a brief clinical examination, intravenous antimalarial should be given in case of pending results of the routine baseline hematological and biochemical tests. A finger prick stick test is useful in the diagnosis and monitoring of hypoglycemia. It should be remembered that false low readings may be obtained with old or damp strips.