27 Year-old With Decreased Mental Status While Hiking

This is unpublished
CT Noncontrast.
CT Noncontrast
Axial FLAIR.
Axial FLAIR
DWI.
DWI
Exponential ADC map (restricted diffusion should be bright).
Exponential ADC map (restricted diffusion should be bright)
T1 axial post Gad.
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