IMPAIRED MICROCIRCULATION AND TISSUE OXYGENATION IN HUMAN CEREBRAL MALARIA - A SINGLE-PHOTON EMISSION COMPUTED-TOMOGRAPHY AND NEAR-INFRAREDSPECTROSCOPY STUDY

Serial single photon emission computed tomography (SPECT), near-infrar ed spectroscopy (NIRS), and transcranial doppler (TCD) sonography exam inations were performed to investigate changes of cerebral perfusion a nd tissue oxygenation in a patient with complicated cerebral malaria t hat have been acquired in Nigeria. On admission to the Neurologic Inte nsive Care Unit in Innsbruck, Austria, SPECT and NIRS revealed focal r ight hemispheric hypoperfusion and decreased oxygen saturation, respec tively, correlating exactly to the patient's right hemispheric localiz ing signs. In contrast, TCD examinations of the basal cerebral vessels revealed normal flow patterns. The patient showed an initial Plasmodi um falciparum parasitemia rate of 30% and was cured by intravenous qui nine and oral mefloquine therapy. He was discharged without neurologic symptoms. Follow-up SPECT and NIRS examinations revealed regular cere bral perfusion and oxygenation patterns in both cortical hemispheres. In summary, the presented findings provide first evidence that noninva sive SPECT and NIRS may be important diagnostic tools in the evaluatio n of impaired cerebral microcirculation in patients with P. falciparum malaria.