High Altitude Cerebral Edema

Excerpt

Each year, more than 200 million individuals travel to high-altitude regions, a number that continues to rise as these areas become more accessible. "High altitude" is defined as elevations exceeding 1,500 m, although high-altitude illnesses (HAIs) rarely occur below 2,500 m. At these elevations, the reduced partial pressure of oxygen produces a range of pathophysiologic effects.

Neurologic manifestations of altitude illness exist along a continuum, from the relatively mild high-altitude headache to the more common acute mountain sickness (AMS), and ultimately to the severe and potentially fatal high-altitude cerebral edema (HACE). HACE is characterized by ataxia, fatigue, and progressive alteration in mental status. The condition is regarded as the terminal or most severe form of AMS and is the least common altitude-related disorder.

Compared with other altitude illnesses, HACE most often develops above 4,000 m and carries a high mortality risk if not rapidly identified and treated. Management requires immediate descent and supplemental oxygen administration, with evacuation and portable hyperbaric chamber therapy as indicated. Given the growing popularity of high-altitude travel, healthcare professionals must provide patient education on preventive measures, symptom recognition, and timely response to altitude illness.