New MRI (MRI) studies have shown that mountain climbers who experience a certain kind of high altitude sickness have traces of bleeding in the brain years following your initial incident, in accordance with a report presented today in the annual meeting of the Radiological Society of North America (RSNA).
High altitude brain edema (HACE) can be a severe and sometimes fatal condition which could affect mountain climbers, hikers, skiers and travelers at high altitudes—typically above 7,000 feet, or 2,300 meters. HACE results from swelling of brain tissue because of leakage of fluids on the capillaries.
Symptoms include headache, decrease of coordination and decreasing stages of consciousness. “HACE can be a life-threatening condition,” said Michael Knauth, M.D., Ph.D., from your University Medical Center’s Department of Neuroradiology in Goettingen, Germany.
“It usually happens in a hostile environment where neither help nor proper diagnostic tools can be purchased.” Dr. Knauth and colleagues with the University Hospitals in Goettingen and Heidelberg, Germany, compared brain MRI findings among four categories of mountaineers: climbers with well documented installments of HACE; climbers that has a good reputation for thin air illness; climbers using a good reputation for severe acute mountain sickness (AMS); and climbers using a good reputation for isolated high altitude pulmonary edema (HAPE), a life-threatening accumulation of fluid inside the lungs that develops at high altitudes.
Two neuroradiologists assessed the brain MRI findings not understanding the status of the mountaineers and assigned a score good number and of any microhemorrhages. “Normally, these microhemorrhages are so small they are only visible which has a special MRI technique called susceptibility-weighted imaging,” Dr. Knauth said. “On this technique, the microhemorrhages are depicted only a small amount black spots.” The MRI results showed brain microhemorrhages almost exclusively in HACE survivors.
With the 10 climbers with a good reputation for HACE, eight had evidence of microhemorrhages on MRI. One other two had uncertain results. Only two in the remaining 26 climbers were positive for microhemorrhages. “It absolutely was previously considered that HACE did not leave any traces inside the brains of survivors,” Dr. Knauth said. “Our research that it is not the case. For several years after, microhemorrhages or microbleeds are visible inside brains of HACE survivors.” Survivors of the extremely clinically severe cases of HACE had probably the most prominent proof microhemorrhages on MRI.
The bleeds were found predominantly in the corpus callosum, the thick band of nerve fibers that connects the right and left halves on the brain, and showed a characteristic distribution different from other vascular diseases like vasculitis, or circulation system inflammation.
“The distribution of microhemorrhages is often a new and sensitive MRI sign of HACE which enables it to be detected years after HACE,” Dr. Knauth said. “We’ll further analyze our clinical and MRI data on patients with acute mountain sickness, that’s considered a precursor of HACE.” For now, Dr. Knauth does not think HACE survivors need to abandon climbing. “We cannot give this kind of strong recommendation,” he said. “However, mountaineers with already experienced HACE once should get used to the altitude very slowly.”
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