High Altitude Cerebral Edema (HACE)

As was described in Acute Mountain Sickness, the hypoxia from altitude causes the brain to swell and the blood vessels to leak fluid. It generally occurs at higher altitudes than HAPE.

Signs and Symptoms

HACE is increasing intracranial pressure. The signs and symptoms are the same as if the mechanism was from trauma.

Early signs are severe headache, altered mental status, and vomiting. As it progresses, the patient may have a decreased level of consciousness and seizures.

Patients with both HACE and HAPE are in DEEP trouble.

Prevention

When the first signs of AMS are experienced, do not ascend any higher. Immediately begin the descent.

Treatment

Descend to a lower altitude as rapidly as possible. The only treatment is reaching greater atmospheric pressure.

There are specialized devices and medications that can be used to buy time, but ultimately the patient needs to descend.