Cerebral malaria-related death caused by brain swelling

Scientists claimed Wednesday they have discovered what causes death in children with cerebral malaria, the deadliest form of the disease that remains a major scourge in Africa.
Terrie Taylor of Michigan State University and her team reported in the New England Journal of Medicine that increased brain volume was seen in children who died of cerebral malaria but was uncommon in those who did not die from the disease.
The researchers found the brain of the deceased becomes so swollen it is forced out through the bottom of the skull and compresses the brain stem, which controls breathing.
They believed that it's this pressure that causes the children to stop breathing and die.
They were also quick to point out that brain swelling is transient and not inevitably fatal.
In the study, about 65 percent of the children with severely increased brain volume survived.
"Because we know now that the brain swelling is what causes death, we can work to find new treatments," Taylor said in a statement.
"The next step is to identify what's causing the swelling and then develop treatments targeting those causes. It's also possible that using ventilators to keep the children breathing until the swelling subsides might save lives, but ventilators are few and far between in Africa at the moment."
The findings were based on brain images from hundreds of children in Malawi, which were taken by magnetic resonance imaging (MRI). MRI is an important diagnostic tool that is so common in developed countries it's even used on family pets, but the technology became available in Malawi only in 2009.
"We found that survivors' brains were either never swollen or decreased in size after two to three days. This was a triumphant moment," Taylor said. "I wanted to say to the parasite 'Ha! You never thought we'd get an MRI, did you?'"
Cerebral malaria is the most severe form of malaria affecting the brain, occurring predominantly in children. About 15 to 25 percent of those children infected by cerebral malaria will eventually die.