High altitude cerebral edema

Background

1. Progressive neurologic deterioration in someone with AMS or HAPE (due to incr ICP)
2. Almost never occurs at <8000ft

Clinical Features

1. Altered mental status, ataxia, gait disturbance, stupor (most sensitive findings)
   1. Progresses to coma if untreated
2. Headache, nausea, and vomiting are not always present
3. Focal neuro deficits may be seen (3rd/6th CN palsies)

Treatment

1. Immediate descent is the treatment of choice
2. If descent not possible use combination of:
   1. Supplemental O2
   2. Dexamethasone 8mg initially, then 4mg q6hr
   3. Hyperbaric bag if available

See Also

High Altitude Medicine

Source

Tintinalli