Stroke at High Altitude in an Experienced Sherpa Climber: A Case Report

Sherpa, Mingma Thsering, and Raksha Shrestha. Stroke at high altitude in an experienced Sherpa climber: A case report. High Alt Med Biol. 21:406-408, 2020.-A 44-year-old experienced Sherpa climber had dizziness with nausea and several episodes of vomiting while at Camp 2 of Mount Everest (6400 m). He was airlifted from Everest Base Camp to Kathmandu for further treatment. Neurological assessment revealed cerebellar signs with ataxia. Sensory examination revealed hypoesthesia on the extremities of the left side and right half of the face. Laboratory workup revealed increased hemoglobin and hematocrit levels. Magnetic resonance imaging of brain revealed ischemic infarction of right cerebellar hemisphere in the right posterior inferior cerebellar artery territory extending to medulla. Patient was managed with aspirin, supportive measures, and physiotherapy, and made a complete recovery after 2 months. This is the first documented case of ischemic stroke in a healthy experienced Sherpa climber. Although the exact cause of stroke in our patient remains uncertain, the prothrombotic state due to high altitude compounded by impaired cerebral autoregulation and dehydration may have been contributory factors.