Höghöjdsödem

Höghöjdsödem, also known as high-altitude cerebral edema (HACE), is a serious and potentially fatal medical condition that can affect individuals traveling to high altitudes. It is a severe form of acute mountain sickness (AMS) characterized by swelling of the brain due to exposure to low oxygen levels at high elevations. The condition typically develops when ascending too quickly to altitudes above 2,500 meters (8,000 feet), although susceptibility varies among individuals.

The exact mechanisms are not fully understood, but it is believed to involve increased blood flow to the brain and leakage of fluid from capillaries into the brain tissue, leading to increased intracranial pressure. Symptoms can include severe headache, confusion, disorientation, loss of coordination (ataxia), drowsiness, and eventually coma and death if not treated promptly. The onset of symptoms can be rapid, often appearing within 12 to 24 hours of reaching a high altitude or shortly after.

Diagnosis is primarily based on clinical presentation, taking into account the patient's altitude exposure and characteristic symptoms. Medical imaging, such as MRI, may reveal cerebral edema. The most crucial step in management is immediate descent to a lower altitude. Supplemental oxygen is also vital. Medications like dexamethasone can help reduce brain swelling and are often administered while descending. Acetazolamide is commonly used for prophylaxis and treatment of AMS, though its role in established HACE is secondary to descent and oxygen. Prevention is key and involves gradual acclimatization, allowing the body time to adjust to lower oxygen levels.