Intracerebral bleed, right haemiparesis and seizures: an atypical presentation ofvivaxmalaria

Abstract

Falciparum malaria is notoriously known to produce life-threatening complications. Despite growing reports of chloroquine resistance and severe disease, vivax malaria continues to be viewed as a benign disease. We report a rare case of a 47-year-old healthy man from a malaria-endemic region, presenting with intracerebral bleed, right haemiparesis, aphasia and seizures following vivax malaria. This was successfully managed conservatively, without any neurosurgical intervention, with combination therapy of intravenous artesunate, oral hydroxychloquine and primaquine. In a country where Plasmodium vivax is responsible for majority of cases of malaria, it is high time the national malaria control programmes focus on the elimination of P. vivax in addition to its more dangerous counterpart, P. falciparum.

Neurological involvement associated with Plasmodium vivax malaria from Pakistan

“…4 Patients presenting with cerebral symptoms such as acute febrile encephalopathy, raised intracranial pressure, intracerebral haemorrhage, hemiparesis, aphasia and seizures following vivax malaria have been reported previously. 5,6…”

Malaria-induced Coagulopathy: Complexities and Treatment Challenges in Intracranial Hemorrhage

“…The types of bleeding that have been recorded include SAH, subdural, intracerebral, and even extradural hemorrhage. 10 Verma et al described a complex case involving a 38-year-old male who presented with brain hemorrhage secondary to suspected malarial coagulopathy. 11 The treatment process was significantly challenging due to rapid neurological decline, anisocoria, low platelet count, and the development of hydrocephalus.…”