High altitude cerebral edema (HACE)

Evidence-based neurology checklist on high altitude cerebral edema (hace): Description This is a syndrome that typically develops at altitudes > 3,000 m It is usually preceded by acute mountain sickness (AMS) It affects about 1% of climbers It is fatal if untreated for > 24 hours Clinical features…

Description

  • This is a syndrome that typically develops at altitudes > 3,000 m
  • It is usually preceded by acute mountain sickness (AMS)
  • It affects about 1% of climbers
  • It is fatal if untreated for > 24 hours

Clinical features

Differential diagnosis

Computed tomography (CT) head: features

Magnetic resonance imaging (MRI) brain: features

Treatment

References

  1. Burtscher M, Hefti U, Hefti JP. High-altitude illnesses: old stories and new insights into the pathophysiology, treatment and prevention. Sports Med Health Sci 2021; 3:59-69. 
  2. Clarke C. Neurology at high altitude. Pract Neurol 2006; 6:230-237.
  3. Singh I, Khanna PK, Srivastava MC, et al. Acute mountain sickness. NEJM 1969; 280:175-184.
  4. Hüfner K, Falla M, Brugger H, et al. Isolated high altitude psychosis, delirium at high altitude, and high altitude cerebral edema: are these diagnoses valid? Front Psychiatry 2023; 14:1221047. 
  5. Kandel K, Regmi PR, Poudel S. Susceptibility - weighted imaging: a valuable diagnostic tool for early detection of high-altitude cerebral edema: a case report. Radiol Case Rep 2023; 18:3089-3092.
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