Treatment Guidelines For Cerebral Malaria: Causes & Symptoms

Malaria is a mosquito borne disease caused by plasmodium parasites. In tropical countries, malaria remains an important health problem. Millions of people die due to complications arising from this parasitic infection especially in tropical countries. Malaria is mainly caused by plasmodium vivax and plasmodium falciparum species. The disease is fairly common after rainy season in tropical and endemic areas.

Cerebral malaria is a neurological complication mainly caused due to plasmodium falciparum infection. Cerebral malaria has high mortality rate. Patients who survive this severe form of malaria may have an increased risk of brain injury that may lead to neurological and cognitive problems.

Patients suffering from cerebral malaria may present with fever, altered consciousness, hypoglycemia, anemia, jaundice, convulsions and coma.

Cerebral malaria is a medical emergency and patients are treated promptly with intravenous antimalarial medicines for a favorable outcome. Without treatment cerebral malaria is a fatal condition.

Causative Organism Of Cerebral Malaria

Cerebral malaria is a severe form of malaria. It is mainly caused by plasmodium falciparum species. Malaria is caused when Anopheles mosquito transmits the parasite in human body during a blood meal. Malaria can be uncomplicated or severe. Cerebral malaria is the commonest form of all complications arising from malarial infection.

The condition carries a high mortality rate of 25 to 30 percent.

In hyperendemic areas of Africa, it is more common in children, pregnant women, and non immune travelers. In endemic areas of Asia, people of all age group can be affected. The reason why brain is affected in malaria is not very well understood. Researchers are of the view that parasites circulating in brain vessels may prevent adequate oxygen and glucose perfusion in the brain tissue. Both of them are important energy source for brain.

Compromised blood flow, severe anemia, hypoglycemia, and intracranial hypertension etc all factors together may lead to cerebral malaria.

Signs And Symptoms Of Cerebral Malaria

Cerebral malaria is most life threatening form of malaria. It is a complication of malaria which affects the brain. Only few early symptoms develop in children as well as adults.

  • High grade Fever
  • Chills accompanying fever
  • Headache
  • Body ache
  • Low blood pressure
  • Anemia
  • Jaundice
  • Enlarged spleen and liver
  • Altered consciousness
  • Delirium
  • Convulsion
  • Blood in urine due to massive destruction of red blood cells.
  • Reduced urine output suggesting kidney failure.
  • Some patients may develop squint.
  • Coma lasting for more than 30 minutes after seizure.
  • Rapid acidotic breathing.

Cerebral malaria can become fatal if the symptoms are not treated on urgent basis.

Treatment And Management Of Cerebral Malaria

Cerebral malaria is a life threatening complication of malaria. This condition is characterized by brain damage. However, prompt diagnosis and treatment can save the person or reduce the mortality rate at large. According to medical science, cerebral malaria has high mortality rate as compared to other forms of malaria.

Patient suffering from or suspected to suffer from cerebral malaria should be shifted in a hospital for emergency treatment. They need intensive care and treatment.

There are many newer anti-malarial drugs found effective in treatment of cerebral malaria. Usually anti -malarial are given intravenously for better effect in fighting against the parasites.

Symptomatic treatment is given for high fever, seizures, etc. Patient comes out of coma within 72 hours of treatment. In majority of cases there is no brain injury left behind. During the treatment patient is constantly monitored for urine output and intake of fluids.


  1. OJ said:

    What is the treatment if kidney is affected in malaria?

    November 3, 2017
    • PUP said:

      Kidney injury due to malaria infection is serious and patient needs prompt hospitalization for treatment. Treatment consists of anti malarial medicines, besides all supportive measures that are required in treatment of acute kidney injury. This may include correction of electrolyte, fluid replacement and dialysis.

      August 21, 2018

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