1/4. Alveolar haemorrhage in a case of high altitude pulmonary oedema.A case of high altitude pulmonary oedema (HAPE) in a climber who made a rapid ascent on Mt McKinley (Denali), alaska is described. The bronchoalveolar lavage (BAL) fluid contained increased numbers of red blood cells and an abundance of haemosiderin laden macrophages consistent with alveolar haemorrhage. The timing of this finding indicates that alveolar haemorrhage began early during the ascent, well before the onset of symptoms. Although evidence of alveolar haemorrhage has been reported at necropsy in individuals dying of HAPE, previous reports have not shown the same abundance of haemosiderin laden macrophages in the BAL fluid. These findings suggest that alveolar haemorrhage is an early event in HAPE.- - - - - - - - - - ranking = 1keywords = haemorrhage (Clic here for more details about this article) |
2/4. High altitude cerebral oedema.High altitude cerebral oedema is a severe form of acute mountain sickness occurring at heights above 4500 metres. The clinical features are of headache, impairment of consciousness and a variety of neurological signs. The condition occurs during acclimatisation and also at extreme altitudes above 7500 metres when it is often fatal. Case histories of cerebral oedema patients, pathological findings and treatment are reviewed. Other forms of altitude-related illness are also reviewed, including stroke and retinal haemorrhage.- - - - - - - - - - ranking = 30.611591140943keywords = retinal haemorrhage, haemorrhage (Clic here for more details about this article) |
3/4. Cerebral form of high-altitude illness.Twelve cases of severe altitude illness are reported in which the neurological signs and symptoms dominated the clinical picture. Pulmonary oedema, retinal haemorrhage, thrombophlebitis and pulmonary embolism, bronchopneumonia, and coronary-artery disease were also present in several of the patients but the primary problem seems to have been cerebral oedema. Other published cases support this impression. patients who were returned to low altitude early in the disease fared well; two patients died, and in both cases evacuation had been delayed. The most effective prevention lies in slow ascent, though in one case reported here the rate of climb was well within the recommended limit. Recommended management is rapid descent to low altitude at earliest indication of cerebral or pulmonary oedema, intravenous dexamethasone or betamethasone in large doses, hydration, diuresis (frusemide has been most used), and perhaps other intravenous therapy with hyperosmolar materials such as mannitol, urea, 50% saline, or 50% sucrose. prognosis is good if descent and treatment are started early, but permanent damage may be anticipated if the patient is unconscious for any prolonged period before descent.- - - - - - - - - - ranking = 30.611591140943keywords = retinal haemorrhage, haemorrhage (Clic here for more details about this article) |
4/4. altitude-related deaths in seven trekkers in the Himalayas.The clinical features and necropsy findings are described for seven trekkers in the Himalayas whose deaths were related to high altitude. The fatal outcome was due to serious pulmonary and cerebral disease. Oedema of the lungs and brain was prominent but so was thrombosis and haemorrhage, features of acute mountain sickness that have received insufficient recognition in the past. Most of the men were middle aged. Some began their trekking soon after flying to high altitude before becoming acclimatised and some remained at high altitude or climbed even higher despite the development of vomiting, breathlessness, and exhaustion. In one case death occurred despite prompt recognition and treatment of symptoms by administration of oxygen and swift evacuation to low altitude.- - - - - - - - - - ranking = 0.125keywords = haemorrhage (Clic here for more details about this article) |