Severe cerebral swelling is not observed in children dying with malaria

In an autopsy study in Abidjan, Côte d'lvoire, 14/155 brains of children <13 years had malaria parasites within cerebral blood vessels. This was associated with cerebral swelling (57% of brains), ventricular compression (86%) and mild basal grooving (43%), but not with coning of the medulla and cerebellum. The pathophysiology of cerebral malaria does not culminate in severe raised intracranial pressure and herniation, and over-concern over the safety of lumbar puncture in malaria may not be warranted.