High Altitude Cerebral Edema (HACE)
Severe AMS with altered mental status, ataxia, and other neurological manifestations such as seizures.
Rare: 1-3%
Can be fatal - fatality rate 60% once patient is comatose
THERAPY:
 1) Descent as soon as possible
 2) Dexamethasone 8 mg load then 4 mg q6 hours
 3) O2 at 2-4 L/hour
 4) If descent not possible consider oxygen and portable hyperbaric chamber.
Etiology of AMS/HACE:
 • Predisposing factors: hypoxia, lowered hypoxic ventilatory response, fluid retention
 • Past occurrence of AMS/HACE strongest risk factor for recurrence
 • Current theories center on role of brain swelling at altitude and raised ICP

Dr. Thomas DeLoughery @Bloodman

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