A rare case of cerebrovascular accident in a child with cerebral malaria, East Africa: a case report

Edwin Joseph Shewiyo, Kenan Bosco Nyalile, Adnan Sadiq, Beatrice Elimringi Maringo, Faith Alexander Mosha, Ronald Mwitalemi Mbwasi, Deborah Nerey Mchaile, Aisa Mamuu Shayo, Sia Emmanueli Msuya
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Malaria is a life-threatening disease caused by female anopheles´ mosquitoes. In 2019, there were an estimated 229 million cases and 409,000 death of malaria worldwide. About 94% of malaria cases and deaths were from Africa, six African countries accounted for approximately half of all malaria deaths worldwide, including Tanzania (5%). The main complications of severe malaria are cerebral malaria, pulmonary edema, acute renal failure, severe anemia, bleeding, acidosis, hypoglycemia and rarely cerebral accident. Cerebral malaria is associated with neurological sequelae such as cortical blindness, ataxia, hemiparesis, tetraparesis, epilepsy, memory impairment, cognitive, language and behavioral problems. A 2 year old boy presented with convulsions, high grade fever, non-projectile vomiting, anaemia, left sided hemiplegia and right sided hemiparesis, the child was mRDT positive blood smear showed hyperparasetimia, and the CT scan showed hypoperfusion on the right basal and thalamus regions, our patient also had history of incomplete antimalarial therapy. The child was treated with artesunate injections, intravenous antibiotics, paracetamol for the fevers, and sodium valproate which relieved the seizures, he was also kept on physiotherapy, improved after 10 days, and he regained full neurological functions and was discharged home