Reduced cerebral blood flow in high altitude climbers

Cerebral blood flow (CBF) was studied by 133Xe inhalation dynamic single photon emission computer tomography in 8 members of a climbing expedition to the Himalayas. With one exception they had all previously climbed at high altitudes. All stayed above 6,500 m for approximately 3 weeks, and 5 reached the summit of Mt. Everest. CBF was measured in Oslo before, immediately after, and one year after the completion of the expedition. Measurements were made at rest and following the injection of 1 g acetazolamide intravenously. As reference group was used 13 healthy male subjects of similar age from the hospital staff. Ten age-matched male diving instructors formed a second control group. In the climbers a small, but not significant reduction in CBF was seen after the expedition. On the other hand, they had significantly lower CBF than reference subjects already before the expedition. The flow difference was most pronounced corresponding to the perfusion territory of the middle cerebral artery. One year after the completion of the expedition the average CBF in climbers was still more than 15% lower than in the reference group. The climbers had higher relative flow increase after acetazolamide injection than the reference subjects, showing that the functional capacity of the microvascular system of the brain was intact. Whether neuronal activity or number of neurones is reduced in climbers proportional to the decrease in flow, or maintained at normal level by increased oxygen and glucose extraction, cannot be answered by the present data.