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27 Year-old With Decreased Mental Status While Hiking
CT Noncontrast
Axial FLAIR
DWI
Exponential ADC map (restricted diffusion should be bright)
T1 axial post Gad
Findings:
High T2 white matter symmetric along frontal lobes and corpus collosum splenium. Nonenhancing and DWI negative
DDX:
Toxic/metabolic insult, ischemia, radiation,
Diagnosis:
High Altitude Cerebral Edema (HACE).
Discussion:
This hiker was climbing a mountain at approximately 4,000 meters and developed mental status changes and headache. Vasogenic edema involving the corpus collosum in a characteristic finding.
Submitted by Dean Shibata, MD, UW Neuroradiology