Isabelle M. MedanaRalf Björn LindertUlrich WursterTran Tinh HienNicholas P.J. DayNguyen Hoan PhuNguyen Thi Hoang MaiLy Van ChuongTran Thi Hong ChauGareth D.H. TurnerJeremy J. FarrarNicholas J. WhiteNuffield Department of Clinical MedicineMedizinische Hochschule Hannover (MHH)UCLOxford University Clinical Research UnitChurchill HospitalMahidol University2018-06-212018-06-212005-08-01Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.99, No.8 (2005), 610-617003592032-s2.0-20444494388https://repository.li.mahidol.ac.th/handle/20.500.14594/16568A retrospective study of cerebrospinal fluid (CSF) markers of brain parenchymal damage was conducted in Vietnamese adults with severe malaria. Three markers were analysed by immunoassays: the microtubule-associated protein tau, for degenerated axons; neuron-specific enolase (NSE), for neurons; and S100B for astrocytes. The mean concentration of tau proteins in the CSF was significantly raised in patients with severe malaria compared with controls (P = 0.0003) as reported for other central nervous system diseases. By contrast, the mean concentration of NSE and S100B remained within the normal range. Tau levels were associated with duration of coma (P = 0.004) and S100B was associated with convulsions (P = 0.006). Concentrations of axonal and astrocyte degeneration markers also were associated with vital organ dysfunction. No association was found between the level of markers of brain parenchymal damage on admission and a fatal outcome. On admission to hospital, patients with severe malaria had biochemical evidence of brain parenchymal damage predominantly affecting axons. © 2005 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1016/j.trstmh.2004.11.017