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 #High #Altitude #Cerebral #Edema #HACE #diagnosis #management
