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High Altitude Cerebral Edema
Aka: High Altitude Cerebral Edema, HACE
- Pathophysiology
- End-stage High Altitude Sickness
- Course from mild ataxia to death can occur within hours
- Symptoms
- See High Altitude Sickness
- Headache
- Signs
- Ataxia
- Screening: Heal-toe walking in a straight line
- Altered Mental Status
- Diagnosis
- Criteria 1
- Mental status changes OR ataxia and
- Acute Mountain Sickness criteria
- Criteria 2
- Mental status changes AND ataxia
- Without Acute Mountain Sickness criteria
- Management
- See High Altitude Sickness
- Gamow Bag
- Descend Immediately
- Dexamethasone
- Initial: 4-8 mg IM/IV/PO
- Later: 4 mg q6h IM/IV/PO
- High flow Supplemental Oxygen
- Intubation and Hyperventilation if patient comatose
- References
- Basnyat (2003) Lancet 361(9373): 1967-74
- Fiore (2010) Am Fam Physician 82(9): 1103-10
- Hackett (2001) N Engl J Med 345(2): 107-14
- Wu (2006) High Alt Med Biol 7(4): 275-80