High altitude cerebral edema
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High altitude cerebral edema (or HACE) is a severe (frequently fatal) form of altitude sickness.[1] HACE is the result of swelling of brain tissue from fluid leakage and almost always begins as acute mountain sickness (AMS)[2]. Symptoms therefore usually include those of AMS (nausea/vomitting, insomnia, weakness, and/or dizziness) plus headache, loss of coordination (ataxia), and decreasing levels of consciousness including disorientation, loss of memory, hallucinations, irrational behavior, and coma.[1][3][2] In some cases the eyes may bulge out from the sockets as the brain swells. In the presence of language barriers, HACE can be assessed by asking (or gesturing) for the climber to walk along a straight line.
HACE is considered to be preventable since it almost always occurs after ascending with the presence of AMS symptoms (one exception is when climbers become stranded for long periods of time at very high altitude (usually above 8,000 meters), especially without bottled oxygen)[2]. Nevertheless, the dangers of HACE are compounded by the tendency of its victims to deny having any problems at all[2]. Often they do not receive treatment until they have collapsed or their symptoms cause others to intervene. Severe instances quickly lead to coma and then death if not treated immediately. Oxygen administration and medications (dexamethasone) may temporarily alleviate symptoms and facilitate descent, which is the necessary life-saving measure. Hyperbaric bags are highly effective in conjunction with dexamethasone and, considering the cost and size of most commercial climbing expeditions, are also relatively cheap and lightweight (15 lbs). Evacuated patients should go to a medical facility for proper follow-up treatment.
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| High altitude cerebral edema | |
| Classification and external resources | |
| ICD-9 | 993.2 |
|---|---|
[edit] See also
[edit] References
- ^ a b Roach, Robert; Stepanek, Jan; and Hackett, Peter. (2002). "24". Acute Mountain Sickness and High-Altitude Cerebral Edema. In: Medical Aspects of Harsh Environments. 2. Washington, DC. http://www.bordeninstitute.army.mil/published_volumes/harshEnv2/harshEnv2.html. Retrieved on 2009-01-05.
- ^ a b c d Dietz,Thomas E. (2000). Altitude Illness Clinical Guide For Physicians. http://www.high-altitude-medicine.com/AMS-medical.html. Retrieved on 2009-05-18.
- ^ AAR Thompson. "Altitude facts". Apex (Altitude Physiology Expeditions). http://www.altitude.org/altitude_sickness.htm. Retrieved on 2007-03-06.
