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This article discusses the complexities and treatment challenges of intracranial hemorrhage caused by malaria-induced coagulopathy. Malaria-induced coagulopathy can disrupt the body's normal clotting mechanism, leading to abnormal bleeding, including intracranial hemorrhage. The exact mechanisms underlying the development of intracranial bleeding in these cases are not fully understood, but it is believed to involve a combination of factors such as endothelial dysfunction, platelet dysfunction, and microvascular sequestration of infected erythrocytes. The management of intracranial hemorrhage associated with malaria-induced coagulopathy presents significant challenges, and further research is needed for better understanding and improved treatment strategies. [Extracted from the article]

This critique discusses neuroprotective strategies for aneurysmal subarachnoid hemorrhage (SAH), excluding Nimodipine, emphasizing alternatives like verapamil, albumin, and cilostazol. While these options show potential, their efficacy lacks robust confirmation from randomized controlled trials (RCTs), relying mainly on observational studies and small trials. The letter underscores the need for comprehensive safety assessments and long-term outcome studies to enhance practical application. Highlighting ongoing trials and emerging therapies like clazosentan and TAK-044, it advocates for future research directions focused on large-scale RCTs and combination therapies, such as cilostazol and Nimodipine, which have demonstrated synergistic benefits in reducing delayed cerebral ischemia (DCI) and improving patient outcomes. [ABSTRACT FROM AUTHOR]

Cold agglutinin-induced hemolytic anemia presents diagnostic and management challenges, particularly in resource-limited settings like Pakistan. A 92-year-old male presented with altered consciousness, fever, weakness, and severe asthenia. Laboratory findings revealed severe anemia, elevated mean corpuscular volume, and deranged renal function tests. The diagnosis was confirmed via a positive Direct Coombs test and elevated cold agglutinin titers. Multidisciplinary management led to symptom resolution, including blood transfusions and immunosuppressive therapy. This case report and literature review emphasize the complexities of diagnosing and managing cold agglutinin-induced hemolytic anemia in Pakistan. By enhancing awareness and understanding of this condition, clinicians can optimize patient outcomes through timely intervention and multidisciplinary care., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Background: Malaria, a prevalent disease in the developing world, is a significant cause of morbidity and mortality. Infection with Plasmodium falciparum , although uncommon, can lead to severe brain injury, including intracranial hemorrhages, resulting in serious neurological deficits. Malaria-induced coagulopathy, while rarely reported, poses a challenge in understanding the exact mechanisms behind the development of intracranial bleeds. Proposed mechanisms include sequestration of parasitized erythrocytes in the brain's microvasculature, leading to capillary occlusion, endothelial damage, cytokine activation, and dysregulation of the coagulation cascade., Case Description: We present the case of a 53-year-old male rapidly deteriorating following a history of traumatic brain injury (TBI). Upon admission, a computed tomography scan revealed bilateral acute on chronic hematomas, necessitating a lifesaving craniotomy. Subsequently, the patient experienced three consecutive recurrent intracranial bleeds post-surgery, attributed to Falciparum -induced coagulopathy. Prompt recognition and intervention stabilized the patient's condition, leading to discharge on the 4 th post-operative day., Conclusion: This case underscores the challenges posed by consecutive recurrent intracranial bleeds following TBI exacerbated by P. falciparum infection. It highlights the obstinate nature of malaria-induced coagulopathy and underscores the importance of timely and aggressive interventions in managing such cases., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Surgical Neurology International.)