Cerebral manifestations of falciparum malaria in adults: more than meets the eye

HighlightsRecent neuroimaging studies using quantitative methods have allowed a better understanding of the pathogenic mechanisms underlying the development and progress of cerebral malaria in adults.These methods have also uncovered brain changes in noncerebral malaria cases, including uncomplicated malaria, underlining a continuum of disease with specific magnetic resonance imaging patterns at each end of the spectrum.Taken together, these findings highlight the potential risk for long-term effects on neurocognition never rigorously evaluated in large cohorts with longitudinal follow-up, using targeted evaluations to detect subtle impairment.AbstractThe application of neuroimaging techniques to patients with Plasmodium falciparum infection has uncovered a wide range of brain changes not only in cerebral malaria but also in noncomatose patients. We propose several hypotheses to unify findings across the spectrum of clinical malaria in adults and highlight the urgent need to evaluate potential long-term effects of cerebral alterations on neurocognition in this understudied age group.