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URMC / Research / Research@URMC / March 2015 / Brain Swelling Source of Malaria’s Fatal Grip

Brain Swelling Source of Malaria’s Fatal Grip

malariaMalaria is one of the world’s deadliest diseases, claiming a child’s life every minute.   New research, published today in the New England Journal of Medicine, reveals why this preventable and treatable disease is often fatal.

Malaria is a mosquito-borne disease caused by a parasite. People with malaria often experience fever, chills, and flu-like symptoms.  If left untreated, individual may develop severe complications and die. There are an estimated 200 million cases of malaria worldwide every year, resulting in more than 600,000 deaths, mostly children in sub-Saharan Africa.

The disease can lead to complications, especially if it is not treated immediately or the species of parasite is drug resistant.  Additionally, it is has not been well understood by what mechanisms the more deadly forms of the disease – such as cerebral malaria – cause death. 

The key to the new discovery was a technology that most people in the developed world take for granted: an MRI.  In 2008, GE Healthcare provided an MRI to Queen Elizabeth Hospital in Blantyre, Malawi.  Previously, the closest MRI was more than a thousand miles away.

Researchers – including URMC neuroradiologist Michael Potchen, M.D., and neurologist Gretchen Birbeck, M.D., M.P.H. – studied the brain images of hundreds of children with cerebral malaria, which is fatal in 15-20 percent of cases.   Birbeck divides her time between Rochester and health projects in Africa. 

The researchers observed that in fatal cases of the disease, the brain becomes so swollen that it is forced out through the bottom of the skull and compresses the brain stem, which causes the children to stop breathing and die. 

The discovery allows researchers to now focus on the cause of the swelling and explore new treatments.

The study was funded by the National Institute of Allergy and Infectious Diseases and included a team of researchers from Michigan State University, the University of Malawi, the University of California, San Diego, the Liverpool School of Tropical Medicine, Harvard University, and Brigham and Women’s Hospital.

Mark Michaud | 3/18/2015

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