• Alice Proia

What is High Altitude Cerebral Edema (HACE)?

High altitude cerebral edema (HACE) is a very serious and often fatal form of altitude illness that involves swelling of a person’s brain due to excess fluid buildup. HACE most often occurs at altitudes greater than 2,500m (8,200ft) when an individual ascends too rapidly and fails to acclimatize properly.


Symptoms include severe headache that is unresponsive to typical pain relief medications (e.g. Tylenol/Paracetamol, Ibuprofen/Advil), dizziness, unusual behavior or confusion, impaired coordination (e.g. slurred speech, difficulty walking), nausea and vomiting, and fatigue.


Onset of symptoms typically occurs after one to two days at high altitude and can progress quickly. Although HACE can happen to anyone, risk factors are thought to include rate of ascent, individuals who have ignored earlier signs of Acute Mountain Sickness (AMS), dehydration, and previous episodes of High Altitude Pulonary Edema (HAPE), HACE or AMS.


Please note that age and physical fitness are NOT thought to be risk factors. HACE, like both HAPE and AMS, can occur in young, healthy, and fit individuals.


HACE is a life-threatening condition and can be fatal if not treated promptly. Rapid descent to a lower elevation is crucial. Treatment may also include supplemental oxygen, use of a portable hyperbaric chamber, and administration of certain medications such as Dexamethasone or Acetazolamide.


If you or anyone in your group experiences any of the symptoms listed above, notify your guide or medic immediately so that appropriate action may be taken.


Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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Altitude Assist is an independently chaired assistance alliance with 3,000+ providers in our network, operating in over 40-countries around the world.