Emergency Medicine Book

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High Altitude Cerebral Edema

Aka: High Altitude Cerebral Edema, HACE
  1. See Also
    1. High Altitude Related-Conditions
    2. High Altitude Sickness (Acute Mountain Sickness)
    3. High Altitude Pulmonary Edema (HAPE)
    4. Portable Hyperbaric Chamber (Gamow Bag)
    5. Lake Louise Acute Mountain Sickness Score
  2. Pathophysiology
    1. End-stage High Altitude Sickness
    2. Course from mild Ataxia to death can occur within hours
  3. Symptoms
    1. See High Altitude Sickness
    2. Headache
  4. Signs
    1. Ataxia
      1. Screening: Heal-toe walking in a straight line
    2. Altered Mental Status
  5. Diagnosis
    1. Criteria 1
      1. Mental status changes OR Ataxia and
      2. Acute Mountain Sickness criteria
    2. Criteria 2
      1. Mental status changes AND Ataxia
      2. Without Acute Mountain Sickness criteria
  6. Management
    1. See High Altitude Sickness
    2. Gamow Bag
    3. Descend Immediately by at least 1000 meters (even 500 meters may be sufficient)
    4. Dexamethasone
      1. Initial: 4-8 mg IM/IV/PO
      2. Later: 4 mg q6h IM/IV/PO
    5. High flow Supplemental Oxygen
    6. Intubation and Hyperventilation if patient comatose
  7. References
    1. Basnyat (2003) Lancet 361(9373): 1967-74 [PubMed]
    2. Fiore (2010) Am Fam Physician 82(9): 1103-10 [PubMed]
    3. Hackett (2001) N Engl J Med 345(2): 107-14 [PubMed]
    4. Wu (2006) High Alt Med Biol 7(4): 275-80 [PubMed]

High altitude cerebral edema (C0472390)

Concepts Disease or Syndrome (T047)
SnomedCT 230762003
English high altitude cerebral edema, high altitude cerebral oedema, High altitude cerebral edema, High altitude cerebral oedema, High altitude cerebral edema (disorder)
Spanish edema cerebral por la altura (trastorno), edema cerebral por la altura
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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