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27 Year-old With Decreased Mental Status While Hiking

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