[Neuromalaria: neuropathological study of 3 cases and review of the literature].

Human Cerebral Malaria (HCM) is an encephalopathy which occurs in some patients infected with P. falciparum (PF). Besides people in the endemic tropical-subtropical zones there is a numerically smaller group of non immune visitors or returning from which are at risk for disease. The histological classical hallmarks of HCM are sequestration of PF-infected erythrocytes in vessels, cerebral oedema, petechial hemorrhages "ring hemorrhages" and so-called Dürk's granulomas. Even though the histological and clinical picture are described for more than a century, some aspects of the pathogenesis of this disease remain obscure. We report the neuropathological findings of three European cases of HCM consisting of a slight diffuse oedema both of cortex and white matter and numerous capillaries filled with parasitized erythrocytes (PRBC). The pathogenetic aspects especially as to concern the sequestration of cerebral vessels are reviewed particularly in regard to the recent immunohistochemical evidence of "intercellular adhesion molecules" (ICAM-1, E-selectin etc.) as ligands to endothelial cells for PRBC.