Cerebral malaria kills hundreds of thousands of people each year. Despite the large death toll, doctors have been stunted in their ability to treat the disease because they did not understand what caused patients to die. Recently, one American doctor was able to answer this question by using Western technology in sub-Saharan setting. MRI scans of malaria-ridden brains revealed that cerebral swelling was the ultimate cause of death in this condition. The discovery is groundbreaking and could potentially help in the developments of treatment for the highly deadly disease.

Yes Malaria Kills… But How?

The answer to how malaria kills has long baffled doctors. After 20 years of studying the condition, Terry Taylor was struck with a brilliant realization: In order to see how cerebral malaria killed, one needed to look at the cerebrum. “And that was when we had the idea—this crazy idea—to bring an MRI to Malawi,” explained Taylor, PRI reported.

 Taylor knew she had to get an MRI machine to the malaria patients being treated where she worked at Queen Elizabeth Hospital in Malawi. How they would obtain the expensive machinery was a bit more complicated. Although they may be common enough in American hospitals, in Malawi and all the surrounding countries, there is no such thing as an MRI machine. Through a combined effort from Taylor and a colleague of hers at Michigan State, General Electric agreed to donate a million-dollar MRI to the African hospital.

What the Scans Revealed

By 2008, the machine was up and running, and Taylor and her team were finally able to see firsthand how malaria affected the brain. A healthy brain scan shows the cerebral tissue surrounded by a thin layer of water. According to PRI, what the researchers saw in malaria-infected brains was significantly different. The disease somehow caused the children’s brains to abnormally swell. In the scans, the researchers witnessed the enlarged brain pushing out its protective layer of water. This left the brain free to push against the children’s skull.

Ultimately, the pressure would affect the area of the brain that regulates breathing. When this occurred, death was almost always guaranteed. After repeating the scans on dozens of sick patients, the researchers were able to come to their final conclusion. In malaria cases where a child’s brain swelled dramatically and irreversibly, the result was almost always death. For those whose brains did not swell at all or were able to return to their normal size, recovery was possible.

Treatment Possibilities

The somewhat small discovery could potentially help those suffering from malaria throughout the world. It suggests a brand new way of treating the disease that may prove more effective than treatments used in the past.

Previously, doctors studying malaria focused on the parasite that caused the disease. Now, using Taylor and her team’s finding, doctors can shift their focus to controlling brain swelling. Swelling may be controllable through both medicinal and surgical methods. “One might be able to reduce the cause of death and the numbers of deaths by using some kind of ancillary treatment that doesn’t attack the infection but attacks this response of the brain,” explained Dyann Wirh, a malaria expert at the Harvard School of Public Health, PRI reported.