Many petechial haemorrhages (up to 600 μm diameter) arising from the rupture of the small vessels of the cerebrum and cerebellum were observed (Figures 4a  and 4b ) Sequestration of PRBC was evident within small blood vessels (Figures 4c and 4d ). Congested larger vessels and areas of haemorrhage showed considerable amounts of malaria pigment (Figures 4e and 4f ). Clumps of platelets or evidence of thrombi in vessels were not seen. There was no evidence of vasculitis or perivascular chronic inflammatory reaction in the brain or any other organ examined (heart, kidney, liver, adrenal gland and spleen). There was no evidence of perivascular or diffuse parenchymal oedema in the brain. Diffuse astrocytosis or microgliosis was not observed, nor was there evidence for acute gliotic reactions about the haemorrhages. There was no aggregation of polymorphs in the vessels, no perivascular inflammation, nor generalized encephalitis. There was no diffuse thrombotic microangiopathy, but within one haemorrhage there was probably some fibrin at the site of the vessel. Immunohistochemistry of sections from the brain was negative for CD54 (which stains intercellular adhesion molecule-1, ICAM-1). Figure 2 Gross appearance of the brain. The outer surface appears dusky with petechial haemorrhages seen on the outer surface of the cerebellum (2a). Cut section of the cerebellum with multiple petechial haemorrhages seen within the cerebellar grey matter (2b).