High altitude cerebral edema
Encyclopedia
High altitude cerebral edema (or HACE) is a severe (frequently fatal) form of altitude sickness
. HACE is the result of swelling of brain tissue from fluid leakage and almost always begins as acute mountain sickness
(AMS). Symptoms therefore usually include those of AMS (nausea/vomiting, insomnia, weakness, and/or dizziness) plus headache, loss of coordination (ataxia
), and decreasing levels of consciousness including disorientation, loss of memory, hallucinations, irrational behavior, and coma. In the presence of language barriers, HACE can be assessed by asking (or gesturing) for the climber to walk along a straight line.
HACE is preventable since it almost always occurs after ascending with the presence of AMS symptoms (one exception is when climbers become stranded for long periods of time at very high altitude, usually above 8,000 meters, especially without bottled oxygen). The dangers of HACE are compounded by the tendency of its victims to deny having any problems at all. They often do not receive treatment until they have collapsed or their symptoms cause others to intervene. Severe instances quickly lead to coma and then death if not treated immediately. Oxygen administration and medications (dexamethasone
) may temporarily alleviate symptoms and facilitate descent, which is the necessary life-saving measure. Hyperbaric bags
are highly effective in conjunction with dexamethasone and, considering the cost and size of most commercial climbing expeditions, are relatively inexpensive and lightweight (15 lbs). Evacuated patients should go to a medical facility for proper follow-up treatment.
Altitude sickness
Altitude sickness—also known as acute mountain sickness , altitude illness, hypobaropathy, or soroche—is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude...
. HACE is the result of swelling of brain tissue from fluid leakage and almost always begins as acute mountain sickness
Altitude sickness
Altitude sickness—also known as acute mountain sickness , altitude illness, hypobaropathy, or soroche—is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude...
(AMS). Symptoms therefore usually include those of AMS (nausea/vomiting, insomnia, weakness, and/or dizziness) plus headache, loss of coordination (ataxia
Ataxia
Ataxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
), and decreasing levels of consciousness including disorientation, loss of memory, hallucinations, irrational behavior, and coma. In the presence of language barriers, HACE can be assessed by asking (or gesturing) for the climber to walk along a straight line.
HACE is preventable since it almost always occurs after ascending with the presence of AMS symptoms (one exception is when climbers become stranded for long periods of time at very high altitude, usually above 8,000 meters, especially without bottled oxygen). The dangers of HACE are compounded by the tendency of its victims to deny having any problems at all. They often do not receive treatment until they have collapsed or their symptoms cause others to intervene. Severe instances quickly lead to coma and then death if not treated immediately. Oxygen administration and medications (dexamethasone
Dexamethasone
Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid drugs. It acts as an anti-inflammatory and immunosuppressant...
) may temporarily alleviate symptoms and facilitate descent, which is the necessary life-saving measure. Hyperbaric bags
Gamow bag
A Gamow bag is an inflatable pressure bag large enough to accommodate a person inside. By inflating the bag with a foot pump, the effective altitude can be decreased by 1000 to as much as 3000 meters . It is primarily used for treating severe cases of altitude sickness.The gamow bag was named after...
are highly effective in conjunction with dexamethasone and, considering the cost and size of most commercial climbing expeditions, are relatively inexpensive and lightweight (15 lbs). Evacuated patients should go to a medical facility for proper follow-up treatment.
Symptoms
Common symptoms of HACE appear in order as followed:- ConfusionConFusionConFusion is an annual science fiction convention organized by the Stilyagi Air Corps and its parent organization, the Ann Arbor Science Fiction Association. Commonly, it is held the third weekend of January. It is the oldest science fiction convention in Michigan, a regional, general SF con...
- Changes in behaviour
- Fatigue
- AtaxiaAtaxiaAtaxia is a neurological sign and symptom that consists of gross lack of coordination of muscle movements. Ataxia is a non-specific clinical manifestation implying dysfunction of the parts of the nervous system that coordinate movement, such as the cerebellum...
- Difficulty speaking
- Vomiting
- HallucinationHallucinationA hallucination, in the broadest sense of the word, is a perception in the absence of a stimulus. In a stricter sense, hallucinations are defined as perceptions in a conscious and awake state in the absence of external stimuli which have qualities of real perception, in that they are vivid,...
s - BlindnessBlindnessBlindness is the condition of lacking visual perception due to physiological or neurological factors.Various scales have been developed to describe the extent of vision loss and define blindness...
- Paralysis of a limbLimb (anatomy)A limb is a jointed, or prehensile , appendage of the human or other animal body....
- SeizureSeizureAn epileptic seizure, occasionally referred to as a fit, is defined as a transient symptom of "abnormal excessive or synchronous neuronal activity in the brain". The outward effect can be as dramatic as a wild thrashing movement or as mild as a brief loss of awareness...
- UnconsciousnessUnconsciousnessUnconsciousness is the condition of being not conscious—in a mental state that involves complete or near-complete lack of responsiveness to people and other environmental stimuli. Being in a comatose state or coma is a type of unconsciousness. Fainting due to a drop in blood pressure and a...
- Total paralysisParalysisParalysis is loss of muscle function for one or more muscles. Paralysis can be accompanied by a loss of feeling in the affected area if there is sensory damage as well as motor. A study conducted by the Christopher & Dana Reeve Foundation, suggests that about 1 in 50 people have been diagnosed...
- ComaComaIn medicine, a coma is a state of unconsciousness, lasting more than 6 hours in which a person cannot be awakened, fails to respond normally to painful stimuli, light or sound, lacks a normal sleep-wake cycle and does not initiate voluntary actions. A person in a state of coma is described as...
See also
- Altitude sicknessAltitude sicknessAltitude sickness—also known as acute mountain sickness , altitude illness, hypobaropathy, or soroche—is a pathological effect of high altitude on humans, caused by acute exposure to low partial pressure of oxygen at high altitude...
- High altitude pulmonary edemaHigh Altitude Pulmonary EdemaHigh altitude pulmonary edema is a life-threatening form of non-cardiogenic pulmonary edema that occurs in otherwise healthy mountaineers at altitudes typically above ....
(HAPE) - High altitude flatus expulsionHigh altitude flatus expulsionHigh altitude flatus expulsion is a gastrointestinal syndrome which involves the spontaneous passage of increased quantities of rectal gases at high altitudes. First described by Joseph Hamel in c...
(HAFE)