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Acute mountain sickness: controversies and advances
Peter Bartsch1, Damian M Bailey, Marc M Berger
1Medical University Clinic, Department of Internal Medicine, Division of Sports Medicine, Heidelberg, Germany. peter_barsch@med.uni-heidelberg.de
High Altitude Medicine & Biology
|July 22, 2004
Summary
Acute mountain sickness (AMS) is not caused by cerebral edema. Oxidative stress plays a role, and acetazolamide remains the preferred medication for preventing AMS.
Area of Science:
- Altitude sickness research
- Human physiology
- Neuroscience
Background:
- Acute mountain sickness (AMS) is a common condition at high altitudes.
- Prevailing theories suggest AMS is caused by cerebral edema and increased intracranial pressure.
Purpose of the Study:
- To review recent findings on the pathophysiology of AMS.
- To evaluate practical aspects of AMS management and prevention.
Main Methods:
- Review of magnetic resonance imaging (MRI) studies on brain volume and edema.
- Analysis of studies on oxidative stress and AMS.
- Evaluation of clinical trials for AMS prevention medications.
Main Results:
- MRI studies show no significant brain edema in early stages of AMS.
- Brain volume increases later, but without clear correlation to symptoms.
- Oxidative stress is implicated in AMS pathophysiology.
- Theophylline shows marginal benefits for AMS, inferior to acetazolamide.
- Ginkgo biloba was ineffective in preventing AMS.
Conclusions:
- Current evidence does not support cerebral edema as the primary cause of AMS.
- Oxidative stress is a key factor in AMS development.
- Acetazolamide is the most effective drug for AMS prevention.
- Further research is needed on antioxidants and lower acetazolamide doses.