| Summary: | Clinical history : Malaria is one of the most common diseases in the tropical countries. Cerebralmalaria is usually a diffuse symmetric encephalopathy with focal signs being unusual.Methods : We present a three-year old girl lapsing into unconsciousness following a seizure whileundergoing treatment for malaria. Imaging revealed a large heterogenous density, left hemisphericacute subdural haematoma with brain herniation. Investigations revealed anaemia, thrombocytopeniaand positive peripheral blood smear for falciparum malaria.Results : Treatment involved surgical evacuation of the clot and the associated subdural empyema,intravenous quinine and antibiotics.Conclusion : This is the second case report of spontaneous subdural empyema in complicatedfalciparum malaria and highlights a rare but surgically manageable complication.
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