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February 1979

Cerebral Malaria-Reply

Author Affiliations

Dept of Neurol Univ of Vermont Burlington, VT 05401
Dept of Neurol National Univ of Colombia School of Med Bogota, Colombia, SA

Arch Neurol. 1979;36(2):119. doi:10.1001/archneur.1979.00500380089020

In Reply.—  We did mention sludging of the circulation and "plugging" of the cerebral capillaries by clumped erythrocytes among the numerous factors that have been implicated in the pathogenesis of cerebral malaria, although inadvertently, no reference to the pioneer work of Knisely et al1-4 was made. We also referred to the work of Dennis et al5-6 on the use of heparin in the treatment of malaria.Many factors related to the role of the parasitized erythrocyte have been implicated in the pathogenesis of cerebral malaria, but the point we wanted to emphasize was that the alterations of the vascular permeability and the obstruction of the circulation occur before the plugging of the vessels by the RBCs, as clearly demonstrated by Maegraith.7 We strongly believe that this early alteration of the vasculature is the result of the immune response of the host to the parasite and that this vasculopathy