Pediatric High Altitude Cerebral Edema in the Nepal Himalayas.


Journal

Wilderness & environmental medicine
ISSN: 1545-1534
Titre abrégé: Wilderness Environ Med
Pays: United States
ID NLM: 9505185

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 01 11 2018
revised: 24 04 2019
accepted: 15 05 2019
pubmed: 16 7 2019
medline: 16 1 2020
entrez: 15 7 2019
Statut: ppublish

Résumé

High altitude cerebral edema (HACE) is a rare complication of ascent to altitudes of over 2500 m (8200 ft). We are not aware of a previously published case report of HACE in a patient under the age of 18 y. We report on 2 cases of suspected HACE in 2 patients, aged 12 and 16 y, who presented to the Manang Himalayan Rescue Association clinic at 3500 m. The 16-y-old patient presented with severe headache, vomiting, and ataxia after rapid ascent to 3800 m. The 12-y-old patient presented with severe headache, vomiting, visual disturbances, and ataxia at 4500 m, which began to resolve with descent to the clinic at 3500 m. Our cases suggest that HACE can occur in children and adolescents. Because there are no specific guidelines for treatment of acute mountain sickness or HACE in patients under the age of 18 y, we recommend treatment as for adults: oxygen, immediate descent, and dexamethasone. Simulated descent in a portable hyperbaric chamber can be used if oxygen is not available and if actual descent is not possible.

Identifiants

pubmed: 31301992
pii: S1080-6032(19)30098-5
doi: 10.1016/j.wem.2019.05.003
pii:
doi:

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

306-309

Informations de copyright

Copyright © 2019 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

Auteurs

Benjamin J Church (BJ)

Department of Emergency Medicine, Baystate Medical Center, Springfield, MA. Electronic address: churchDO@baystatehealth.org.

Buddha Basnyat (B)

Himalayan Rescue Association, Kathmandu, Nepal.

Ben Mattingly (B)

Department of Emergency Medicine, Baystate Medical Center, Springfield, MA.

Ken Zafren (K)

Department of Emergency Medicine, Stanford University Medical Center, Stanford, CA.

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Classifications MeSH