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Case Reports
. 2023 Feb 27;18(5):1705-1709.
doi: 10.1016/j.radcr.2023.01.071. eCollection 2023 May.

High-altitude cerebral edema manifesting as T2/FLAIR hyperintensity and microbleeds in the white matter on MRI brain

Muhammad Aman  1 , Muhammad Sami Alam  1 , Faheemullah Khan  1 , Shayan Sirat Maheen Anwar  1 , Anwar Ahmed  1 , Ubaid Khan  2 , Umar Khan Bazai  2
Affiliations
Case Reports

High-altitude cerebral edema manifesting as T2/FLAIR hyperintensity and microbleeds in the white matter on MRI brain

Muhammad Aman et al. Radiol Case Rep. .

Abstract

High-altitude cerebral edema is a rare type of acute mountain illness characterized by consciousness disruption and truncal ataxia. Here we discuss a 40-year-old nondiabetic, nonsmoker male who went on a tour to Nanga Parbat. On returning home, the patient developed symptoms of headache, nausea, and vomiting. His symptoms worsened with time and he developed lower limb weakness and shortness of breath. Later, he underwent a computerized tomography chest scan. On the basis of CT scan findings, the doctors decided that the patient was suffering from COVID-19 Pneumonia despite having negative COVID-19 PCR tests multiple times. Later, the patient presented to our hospital with similar complaints. MRI of the brain revealed T2/fluid-attenuated inversion recovery hyperintense and T1 hypointense signals in the bilateral semioval centrum, posterior periventricular white matter, and corpus callosum genu, body, and splenium. These abnormal signals were discovered to be more evident in the corpus callosum's splenium. Moreover, susceptibility-weighted imaging revealed micro hemorrhages in the corpus callosum. This verified the diagnosis that the patient is suffering from high-altitude cerebral edema. Within 5 days, his symptoms resolved and he was discharged with full recovery.

Keywords: Brain hyperintensity; Brain imaging; Cerebral edema; High attitude edema; MRI brain.

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Figures

Fig 1
Fig. 1
(A-D) T2/FLAIR Hyperintense signals in the periventricular deep white matter and the genu, splenium and splenium of the corpus callosum. (E) T1 hypointense signals in the genu, body and splenium of the corpus callosum. (F) Diffuse micro hemorrhages in the corpus callosum on SWI. (G, H) Diffusion restriction in the splenium of corpus callosum. SWI, susceptibility-weighted imaging.
Fig 2
Fig. 2
(A, B) Bilateral perihilar airspace opacification with smooth interlobular septal thickening representing interstitial pulmonary edema. (C) Interval resolution of pulmonary edema.
See this image and copyright information in PMC

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