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Neurology at high altitude

Consultant Neurologist, Whipps Cross University Hospital, London, UK and National Hospital for Neurology & Neurosurgery, London, UK

Correspondence to:
Correspondence to:
Dr C Clarke, National Hospital for Neurology & Neurosurgery, Queen Square, London WC1N 3BG, UK; charles.
clarke@uclh.org

The first 150 words of the full text of this article appear below.

Summit of Brammah 6040 m, Kashmir, 1971. Photo: Henry Edmundson (Charles Clarke Collection)

The finer points of clinical neurology may seem of little relevance when climbing in the Himalaya at 6000 metres or stormbound in a tent, but this is often the setting for high altitude cerebral oedema—the distinct, potentially fatal neurological sequel of chronic hypobaric hypoxia where there is overperfusion of the brain with widespread cerebral oedema, raised intracranial pressure, followed by coma and sometimes death. This brief review explains what is known about the condition, first recognised in climbers and trekkers above 4000 m, and summarises some other ways in which the brain may be affected at high altitude.

ACUTE AND CHRONIC HYPOXIA: ACUTE MOUNTAIN SICKNESS

The decline in atmospheric oxygen with altitude and the oxygen cascade from ambient air to venous blood are shown in figures 1 and 2. The arterial pO₂ in mmHg corresponds closely to the percentages on the horizontal axis . . . [Full text of this article]