High Altitude Cerebral Edema

HIGH ALTITUDE CEREBRAL EDEMA

High Altitude Cerebral Edema (HACE), is a condition associated with severe Acute Mountain Sickness. It occurs due to swelling of the brain tissue from fluid build up in the cranium. It is a life threatening condition.

On Kilimanjaro, people suffering from HACE should descend immediately and seek medial attention when they get to the lower reaches of the mountain.

HACE can be identified if someone is suffering from the following symptoms:

Severe headaches which cannot be relieved by medication
Hallucination
Loss of consciousness
Disorientation
Loss of coordination (i.e. ataxia)
Memory loss
Coma

HACE tends to set in at night. Do not hang around until morning if someone in your group is suffering HACE symptoms. The longer you wait at altitude the greater the probability of fatality. Descend immediately – even under darkness. Under no circumstances should one ascend if they have suspected HACE symptoms. If you have oxygen it can be administered along with a steroid called, dexamethasone, but these should only be used in conjunction with rapid descent.

HIGH ALTITUDE PULMONARY EDEMA

High Altitude Pulmonary Edema (HAPE) is a condition associated with Acute Mountain Sickness and occurs because of fluid build up in the lungs.

Fluid in the lungs prevents the effective exchange of oxygen and thus a decrease of oxygen into the bloodstream.

HAPE almost always occurs because of ascending too high, too fast.
It is a life threatening condition and therefore every precaution should be taken to avoid it when trekking Mount Kilimanjaro.

Clear symptoms that one is suffering from HAPE include:

Very short of breath, even while resting
Very tight chest
The feeling of suffocation, particularly while sleeping
Coughing that brings up white, frothy fluid
Extreme fatigue and weakness
Confusion, hallucination and irrational behaviour

If the last symptom occurs (i.e. confusion, hallucination and irrational behaviour) one can assume that the pulmonary edema has started to affect the brain due to a lack of oxygen in the bloodstream.

Any available oxygen should be administered. The drug, Nifedipine, has been shown to ameliorate the condition, but descent is the only cure.

Trekkers should take care to ensure that the person descending with High Altitude Pulmonary Edema doesn’t exert themselves as this can result in worsening of the condition. A stretcher evacuation is the preferred method of descent.

Once the person has reached the lower limits of the mountain, medical support should be sought immediately.

High Altitude Cerebral Edema