High Altitude Cerebral Edema: Cerebral Acute Mountain Sickness

Cerebral Venous Sinus Thrombosis Masquerading as High Altitude Cerebral Edema at Extreme Altitude

“…6,14 It has also been reported in fatal cases of HACE. 15 Treatment modalities with anticoagulation, thrombolysis, and mannitol administration are dependent on diagnosis and require monitoring under intensive care due to the risk of hemorrhage into venous infarcts. Immediate treatment with repeated doses of low molecular weight heparin, even if initiated at extreme altitude, may need to be continued for weeks or months at an institutional facility depending upon the extent of the thrombosis.…”

How Do You Approach Seizures in the High Altitude Traveler?

“…Although seizures are seen in HACE, their frequency is exceedingly rare, and the mechanism of edema and its contribution to epileptogenesis are unknown (Hackett and Roach, 2001). In the largest series of 44 patients with HACE, no cases of convulsions were reported (Dickinson, 1983). In their review, Hackett and Roach (2004) agree that ''seizures appear to be rare,'' and report four representative cases, none of which presented with seizure.…”

High Altitude Brain Swelling

“…The most common neurological features of HACE are disturbance of consciousness, ataxia, papilledema, urinary retention or incontinence and abnormal plantar reflexes [3]. Abnormal limb tone and power, pupil difference, visual field loss, speech difficulty and hearing loss are amongst the some uncommon features [3].…”

“…Abnormal limb tone and power, pupil difference, visual field loss, speech difficulty and hearing loss are amongst the some uncommon features [3]. Autopsy studies of HACE patients [4,5] reveal edematous brain with flattening of gyri and obliteration of sulci with evidence of uncal and tonsilar herniation commonly associated with peticheal hemorrhages.…”