Cerebral Edema in Chronic Mountain Sickness: a New Finding
Haihua Bao1, Duoyao Wang1, Xipeng Zhao1
1Department of Medical Imaging Center, Affiliated Hospital of Qinghai University, Xining, Qinghai, China.
Scientific Reports
|February 25, 2017
Summary
Chronic mountain sickness (CMS) can cause neurological deterioration due to cerebral edema. This previously unrecognized complication involves hypoxemia and polycythemia, impacting cerebral blood flow and potentially leading to encephalopathy.
Area of Science:
- Neurology
- Altitude Medicine
- Physiology
Background:
- Chronic mountain sickness (CMS) affects individuals living at high altitudes.
- Neurological deterioration, or encephalopathy, is a serious concern in CMS patients.
- The underlying mechanisms of CMS-related encephalopathy require further investigation.
Purpose of the Study:
- To investigate the potential complication of cerebral edema in CMS patients with neurological deterioration.
- To compare hemodynamic and physiological parameters between CMS patients with and without encephalopathy, and healthy controls.
Main Methods:
- Study included 45 subjects permanently residing at 3200-4000m: 9 CMS patients with encephalopathy, 21 CMS patients without encephalopathy, and 15 healthy controls.
- Measurements included CMS symptom score, multi-slice CT, perfusion CT, pulse oximetry (SpO2%), and hemoglobin concentration (Hb).
- Cerebrospinal fluid (CSF) pressure was measured in some patients; MRI was performed in one patient.
Main Results:
- CMS patients exhibited lower SpO2, higher Hb, increased brain blood density, reduced cerebral blood flow (CBF), and circulatory delay compared to controls.
- CMS patients with neurological deterioration showed diffuse cerebral edema and more abnormal cerebral hemodynamics.
- Elevated CSF pressure was observed in CMS patients with cerebral edema.
Conclusions:
- Cerebral edema is a previously unrecognized complication of CMS that can cause encephalopathy.
- Exaggerated polycythemia, hypoxemia, and impaired CBF appear to contribute to this complication.
- Further research is needed to identify triggers for cerebral edema in CMS to improve patient outcomes.
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