Pediatric High Altitude Cerebral Edema in the Nepal Himalayas

We report on 2 cases of suspected HACE in 2 patients, aged 12 and 16 y, who presented to the Manang Himalayan Rescue Association clinic at 3500 m. The 16-y-old patient presented with severe headache, vomiting, and ataxia after rapid ascent to 3800 m. The 12-y-old patient presented with severe headache, vomiting, visual disturbances, and ataxia at 4500 m, which began to resolve with descent to the clinic at 3500 m. Our cases suggest that HACE can occur in children and adolescents. Because there are no specific guidelines for treatment of acute mountain sickness or HACE in patients under the age of 18 y, we recommend treatment as for adults: oxygen, immediate descent, and dexamethasone. Simulated descent in a portable hyperbaric chamber can be used if oxygen is not available and if actual descent is not possible.
Source: Wilderness and Environmental Medicine - Category: Environmental Health Source Type: research

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Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research
Rationale: Giant cell arteritis (GCA) is known to present with typical manifestations like temporal headache and visual abnormalities. However, several cases with atypical manifestations were reported. Stroke occurs in 3% to 7% of patients with GCA. Patient concerns: A 67-year-old male patient with known hypertension presented with somnolence, disorientation and mild bilateral limb ataxia. The magnetic resonance imaging showed multiple acute infarctions in the territory of the vertebrobasilar system with occlusion of the left vertebral artery. Diagnosis: Ten months later, during a routine neurovascular follow-up, r...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
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Source: Journal of Neurology - Category: Neurology Source Type: research
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Source: Journal of Neuro-Ophthalmology - Category: Opthalmology Tags: Disease of the Year: Migraine Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
Authors: Kashikar SV, Lakhkar B, Pandey A, Gupta A Abstract An adolescent presented with headache and projectile vomiting and showed ataxia, dysarthia and nystagmus with normal cognition. A diagnosis of acute cerebellitis was made on the basis of computed tomography and magnetic resonance imaging findings. He developed seizures and had a rapid downhill course with death at 48 hours after admission. Clinically, patients of acute cerebellitis present with fever, nausea, headache and altered sensorium with cerebellar symptoms. Inflammation of the cerebellum compresses the brain stem and induces mental alterations. It ...
Source: Oman Medical Journal - Category: Middle East Health Tags: Oman Med J Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
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Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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Source: Frontiers in Neurology - Category: Neurology Source Type: research
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