Reversible abnormalities of DWI in high-altitude cerebral edema

Abstract

Cerebral sinus thrombosis (CST) can cause cerebral venous infarcts, frequently hemorrhagic. CST has many etiologies including otitis media, trauma, pregnancy, hypercoagulable states, and cancer. Systemic thrombosis is well recognized in cancer patients because of associated hypercoagulability, metastatic spread, and direct tumor infiltration and as a complication of chemotherapy. 1 Tamoxifen, a selective estrogen-receptor modulator, is the most common hormonal therapy in the treatment and prophylaxis of breast cancer. One of its known side effects is systemic thromboembolic events. 2 Recently, two reports have related tamoxifen to CST in absence of other risk factors. 3,4 To confirm this association, we report two patients receiving tamoxifen treatment who developed CST.

Cerebral Diffusion and T2: MRI Predictors of Acute Mountain Sickness during Sustained High-Altitude Hypoxia

“…Previous reports of MRI in severe AMS and HACE describe a reversible vasogenic edema in the splenium. 3,15 This correlates with our findings in the current study that during AMS symptoms, the only cerebral area with a vasogenic pattern of increased ADC is the splenium of the corpus callosum.…”

Human behaviour and development under high‐altitude conditions

“…Leuko-araiosis, defined by Hachinski, Potter and Merskey (1987) as neuroradiological/MRI signal change in the periventricular deep white matter, may reflect exposure to critical levels of environmental hypoxia (Houston, Sutton, Cymerman & Reeves, 1987). Similarly, high signal intensity in the splenium of the corpus callosum following rapid ascent to 5200 m was reported in one 29-year-old man, although this signal change normalized after four months (Wong, Turner, Birchall, Walls, English & Schmid, 2004), and two climbers showed high signal intensity in periventricular brain areas immediately after exposure to 8000 m (Garrido, Segura, Capdevila, Aldoma, Rodriguez, Javierre & Ventura, 1995). Usui, Inoue, Kimura, Kirino, Nagaoka, Abe, Nagata and Arai (2004) described computerized tomography and MRI findings in two women aged 63 years.…”

Clinical Applications of Diffusion

“…In a simulated study of acute high altitude sickness by exposure to normobaric hypoxia, some patients had decreased ADC values in the splenium of the corpus callosum in addition to mild generalized increase in cerebral volume and edema [206]. One case report describes a T2 hyperintense lesion with elevated ADC in the splenium of the corpus callosum, but the MRI was performed 14 days after symptom onset [207].…”