CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2018; 28(04): 401-405
DOI: 10.4103/ijri.IJRI_296_18
Neuroradiology & Head and Neck Imaging

Neuroimaging features of fatal high-altitude cerebral edema

Gorky Medhi
Department of Radiology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim
,
Tsella Lachungpa
Department of Radiology, Sikkim Manipal Institute of Medical Sciences, Gangtok, Sikkim
,
Jitender Saini
Department of Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
› Institutsangaben

Verantwortlicher Herausgeber dieser Rubrik: Financial support and sponsorship Nil.

Abstract

Acute high-altitude cerebral edema can occur in an unacclimatised individual on exposure to high altitudes and sometimes it can be fatal. Here we have described the neuroimaging features of a patient who suffered from fatal high altitude cerebral edema. Available literature is reviewed. Probable pathogenesis is discussed. The risk of acute mountain sickness is reported up to 25% in individuals who ascend to an altitude of 3500 meter and in more than 50% subjects at an altitude of 6000 meter. The lack of availability of advanced imaging facilities at such a higher altitude makes imaging of such condition a less described entity.



Publikationsverlauf

Artikel online veröffentlicht:
26. Juli 2021

© 2018. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Basnyat B, Murdoch DR. High-altitude illness. Lancet 2003; 9373: 1967-74
  • 2 Netzer N, Strohl K, Faulhaber M, Gatterer H, Burtscher M. Hypoxia-related altitude illnesses. J Travel Med 2013; 20: 247-55
  • 3 Luks AM, Swenson ER, Bärtsch P. Acute high-altitude sickness. Eur Respir Rev 2017; 26: 160096
  • 4 Jensen JD, Vincent AL. Altitude Illness, Cerebral Syndromes, High Altitude Cerebral Edema (HACE) [updated 2017 Oct 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430916/. [Last accessed on 2018 Jul 08] [Last updated on 2017 Oct 09]
  • 5 Hackett PH, Yarnell PR, Hill R, Reynard K, Heit J, McCormick J. High altitude cerebral edema evaluated with magnetic resonance imaging: Clinical correlation and pathophysiology. JAMA 1998; 280: 1920-5
  • 6 Hackett PH. The cerebral etiology of high-altitude cerebral edema and acute mountain sickness. Wilderness Environ Med 1999; 10: 97-109
  • 7 Peacock AJ. Oxygen at high altitude. BMJ 1998; 317: 1063-6
  • 8 Bailey DM, Bartsch P, Knauth M, Baumgartner RW. Emerging concepts in acute mountain sickness and high-altitude cerebral edema: From the molecular to the morphological. Cell Mol Life Sci 2009; 66: 3583-94
  • 9 Schoonman GG, Sandor PS, Nirkko AC, Lange T, Jaermann T, Dydak U. et al. Hypoxia-induced acute mountain sickness is associated with intracellular cerebral edema: A 3 T magnetic resonance imaging study. J Cerebral Blood Flow Metab 2008; 28: 198-206
  • 10 Pichler Hefti J, Hoigne-Perret P, Kottke R. Extensive microhemorrhages of the cerebellar peduncles after high-altitude cerebral edema. High Alt Med Biol 2017; 18: 182-4
  • 11 Schommer K, Kallenberg K, Lutz K, Bärtsch P, Knauth M. Hemosiderin deposition in the brain as footprint of high-altitude cerebral edema. Neurology 2013; 81: 1776-9
  • 12 Wong SH, Turner N, Birchall D, Walls TJ, English P, Schmid ML. Reversible abnormalities of DWI in high-altitude cerebral edema. Neurology. 2004; 62: 335-6
  • 13 Dickinson J, Heath D, Gosney J, Williams D. Altitude-related deaths in seven trekkers in the Himalayas. Thorax 1983; 38: 646-56
  • 14 Kallenberg K, Dehnert C, Dorfler A, Schellinger PD, Bailey DM, Knauth M. et al. Microhemorrhages in nonfatal high-altitude cerebral edema. J Cereb Blood Flow Metab 2008; 28: 1635-42
  • 15 Vernooij MW, Ikram MA, Tanghe HL, Vincent AJ, Hofman A, Krestin GP. et al. Incidental findings on brain MRI in the general population. N Engl J Med 2007; 357: 1821-8
  • 16 Blitstein MK, Tung GA. MRI of cerebral microhemorrhages. Am J Roentgenol 2007; 189: 720-5