• Shih-Shan Lang, William Paden, Andrew P Steenhoff, Kevin Hines, Phillip B Storm, and Jimmy Huh.
• Division of Neurosurgery, Department of Neurosurgery, Children's Hospital of Philadelphia, University of Pennsylvania, Perelman School of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: chens4@email.chop.edu.
• World Neurosurg. 2020 Sep 1; 141: 115-118.

BackgroundPediatric cerebral malaria (CM) is a severe complication of Plasmodium falciparum that often leaves survivors with severe neurologic impairment. Increased intracranial pressure (ICP) as a result of cerebral edema has been identified as a major predictor of morbidity and mortality in CM. Past studies have demonstrated that survivors are more likely to have resolution of elevated ICP and that efficient management of ICP crises may lead to better outcomes. However, data on invasive brain tissue oxygen monitoring are unknown.Case DescriptionWe report a case of a pediatric patient with cerebral malaria who developed encephalopathy and cerebral edema and describe the pathophysiology of this disease process with invasive ICP and brain tissue oxygen multimodality neuromonitoring. The utilization of both ICP and brain tissue oxygen monitoring allowed prompt diagnosis and successful treatment of severe intracranial hypertension and low brain tissue oxygenation crisis. The patient was discharged to home in good neurologic condition.ConclusionsMultimodality neuromonitoring may be considered in pediatric patients who have cerebral edema and encephalopathy from CM.Copyright © 2020 Elsevier Inc. All rights reserved.

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