High altitude cerebral edema
Revision as of 20:47, 11 January 2015 by Rossdonaldson1 (talk | contribs)
Background
- Progressive neurologic deterioration in someone with AMS or HAPE (due to incr ICP)
- Almost never occurs at <8000ft
Clinical Features
- Altered mental status, ataxia, gait disturbance, stupor (most sensitive findings)
- Progresses to coma if untreated
- Headache, nausea, and vomiting are not always present
- Focal neuro deficits may be seen (3rd/6th CN palsies)
Differential Diagnosis
High Altitude Illnesses
- Acute mountain sickness
- Chronic mountain sickness
- High altitude cerebral edema
- High altitude pulmonary edema
- High altitude peripheral edema
- High altitude retinopathy
- High altitude pharyngitis and bronchitis
- Ultraviolet keratitis
Treatment
- Immediate descent is the treatment of choice
- If descent not possible use combination of:
- Supplemental O2
- Dexamethasone 8mg initially, then 4mg q6hr
- Hyperbaric bag if available
See Also
Source
Tintinalli