Hemosiderin deposition in the brain as footprint of high-altitude cerebral edema

Objective: Based on recent findings of microhemorrhages (MHs) in the corpus callosum (CC) in 3 individuals after nonfatal high-altitude cerebral edema (HACE), we hypothesized that hemosiderin depositions in the brain after high-altitude exposure are specific for HACE and remain detectable over many...

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Hauptverfasser: Schommer, Kai (VerfasserIn) , Kallenberg, Kai (VerfasserIn) , Lutz, Kira (VerfasserIn) , Bärtsch, Peter (VerfasserIn) , Knauth, Michael (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: October 9, 2013
In: Neurology
Year: 2013, Jahrgang: 81, Heft: 20, Pages: 1776-1779
ISSN:1526-632X
DOI:10.1212/01.wnl.0000435563.84986.78
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1212/01.wnl.0000435563.84986.78
Verlag, lizenzpflichtig, Volltext: https://n.neurology.org/content/81/20/1776
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Verfasserangaben:Kai Schommer, Kai Kallenberg, Kira Lutz, Peter Bärtsch, Michael Knauth

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520 |a Objective: Based on recent findings of microhemorrhages (MHs) in the corpus callosum (CC) in 3 individuals after nonfatal high-altitude cerebral edema (HACE), we hypothesized that hemosiderin depositions in the brain after high-altitude exposure are specific for HACE and remain detectable over many years. - Methods: This was a cross-sectional study involving 37 mountaineers in 4 groups: 10 had experienced HACE, 8 high-altitude pulmonary edema, 11 severe acute mountain sickness, and 8 had climbed to altitudes ≥6,962 m without developing any high-altitude illness. HACE was defined as ataxia necessitating assistance with walking and/or decreased consciousness. Within <1 to 38 months after the qualifying incident, MRI of the brain was performed using a 3-tesla scanner and high-resolution susceptibility-weighted magnetic resonance sequences for detection of hemosiderin depositions, which were quantified by a score. - Results: Unequivocal MHs located in the splenium of the CC were found in 8 subjects and questionable MHs were found in 2 subjects 1 to 35 months after HACE. They were located outside the CC in 5 more severe cases. MHs remained unchanged in those reexamined after 12 to 50 months. A few unequivocal MHs in the splenium of the CC were found in one subject after severe acute mountain sickness, while one subject with high-altitude pulmonary edema and 2 of the extreme altitude climbers had questionable lesions. In all other subjects, MHs were unequivocally absent. - Conclusions: MHs detectable by susceptibility-weighted MRI predominantly in the splenium of the CC are long-lasting footprints of HACE. 
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