41. Outdoor Health - High-Altitude Cerebral Edema Home Medical Reference Outdoor Health / Safety HighAltitude CerebralEdema. High-altitude cerebral edema (HACE) is the medical http://www.umm.edu/outdoor/hace.htm

Home Medical Reference Outdoor Health / Safety High-Altitude Cerebral Edema High-altitude cerebral edema (HACE) is the medical term for a disorder (theoretically linked to brain swelling) that involves an alteration of mental status seen at high altitude, related to diminished atmospheric oxygen. Symptoms include difficulty walking (inability to walk a straight line, staggering, or frank inability to walk), headache (often throbbing), confusion, difficulty in speaking, drowsiness, vomiting, and, in severe cases, blindness, unconsciousness, paralysis, and/or coma. A victim may suffer from HACE and high-altitude pulmonary edema (HAPE) at the same time. Other symptoms may include hallucinations, paralysis of an arm and/or leg, and seizures. Victims are often gray or pale in appearance. Imbalance or the inability to walk heel to toe in a straight line is a very worrisome sign and should prompt immediate action to treat the victim. The treatment for HACE is immediate descent to an altitude below one at which the victim previously had no symptoms, and the

42. CJNS - Addison's Disease Presenting With Cerebral Edema Abstract, Close Window Addison's Disease Presenting with CerebralEdema. Caroline Geenen, Ingrid Tein and Robert M Ehrlich. Abstract http://www.canjneurolsci.org/23maytoc/addisons.htm

Abstract Close Window Addison's Disease Presenting with Cerebral Edema Caroline Geenen, Ingrid Tein and Robert M Ehrlich Abstract: Background: Increased intracranial pressure with encephalopathy has rarely been reported in Addison's disease. Method: Case Study. Results: Conclusion: Addison's Disease should be considered in the differential diagnosis of symptomatic cerebral edema and idiopathic intracranial hypertension. Can. J. Neurol. Sci. 1996; 23: 141-145 For information about this web site e-mail to: journal@cjns.org

43. Development Of Cerebral Edema, Depending On The Expressiveness Of Development of cerebral edema, Depending On The Expressiveness of Anemia InNeurosurgical Patients At The Early PostOperative Stage GI Ingorokva. http://www.medlib.am/2000_3_16AE.htm

44. HACE - High Altitude Cerebral Edema HACE High Altitude cerebral edema AMS is a spectrum of illness, frommild to life-threatening. At the severely ill end of this http://www.basecampmd.com/altitudeguide/hace.htm

HACE - High Altitude Cerebral Edema AMS is a spectrum of illness, from mild to life-threatening. At the "severely ill" end of this spectrum is High Altitude Cerebral Edema; this is when the brain swells and ceases to function properly. HACE can progress rapidly, and can be fatal in a matter of a few hours to one or two days. Persons with this illness are often confused, and may not recognize that they are ill. Descend immeadiately People with HACE usually survive if they descend soon enough and far enough, and usually recover completely. The staggering gait may persist for days after descent. Once recovery has been complete, and there are no symptoms, cautious re-ascent is acceptable. Back to main page...

45. Development Of Cytotoxic Cerebral Edema In Rats Following Intracaudatum Injectio Development of cytotoxic cerebral edema in rats following intracaudatuminjection of tACPD, an agonist of metabotropic glutamate receptors. http://www.cmj.org/813.htm

Development of cytotoxic cerebral edema in rats following intracaudatum injection of tACPD, an agonist of metabotropic glutamate receptors YUAN FangÔ¬·¼, WANG TianyouÍõÌìÓÓ, LUO LinÂÞ ÷ë, SUN YilinËïÒìÁÙ, ZHANG LiÕÅ Àò and QU BaoqingÇú±¦Çå Beijing Neurosurgical Institute, Beijing 100050, China (Yuan JF, Wang TY, Luo L, Sun YL, Zhang L and Qu BQ) Correspondence to: Yuan Fang, Beijing Neurosurgical Institute, Beijing 100050, China (Tel: 010-67016611-2650. Fax: 010-67018349. Email: yfang@btamail.net.cn) Objective To explore the involvement of metabotropic glutamate receptors (mGluRs) in the formation of cerebral edema. Methods Male Wistar rats weighing from 250 g to 300 g were used. Trans-1-aminocyclopentane-1,3-diacarboxylic acid (tACPD), an agonist of mGluRs, was microinjected into the right caudatum. Brain water content was determined by a wet weight / dry weight technique and Na+, K+ and Ca2+ contents were measured by Inductive Couple Plasma-9000 at 6 h, 24 h and 48 h post-injection. Extravasation of Evan's blue (EB) into the brain was an indicator of disturbance in the blood-brain barrier (BBB) and endothelial cells. Histologic studies were performed under a Leitz microscope and a Philips EM208s electron microscope. Results Dose-dependent and time-related increase of brain water was induced after tACPD (10, 50, 500 and 1000 nmol ) injection. A significant increase in Na+ and K+ content but not in Ca2+ content was observed. EB extravasation showed no blue stain, indicating no increase in BBB permeability induced by tACPD-injection. Electron microscope study confirmed this finding and revealed remarkable swelling of astrocytes especially endfoot processes of astrocytes around capillaries at 6 h after tACPD-injection. In addition, all changes mentioned above occurred in both caudatum.

46. BioMed Central | Abstract | Cerebral Edema In Children With Diabetic Ketoacidosi Report cerebral edema in Children with Diabetic Ketoacidosis Nicole Glaser MDSchool of Medicine, 2516 Stockton Boulevard, University of California Davis http://www.biomedcentral.com/1534-4827/1/41/abstract

Welcome guest user home journals A-Z journals by subject advanced search ... Issue 1 Viewing options Abstract Full text PDF Other links: E-mail to a friend Download references Post a comment Search PubMed For Glaser N Report Cerebral Edema in Children with Diabetic Ketoacidosis Nicole Glaser MD School of Medicine, 2516 Stockton Boulevard, University of California Davis, Sacramento, CA, 95817, USA. Current Diabetes Reports Abstract Cerebral edema is the most frequent serious complication of diabetic ketoacidosis (DKA) in children, occurring in 1% to 5% of DKA episodes. The rates of mortality and permanent neurologic morbidity from this complication are high. The pathophysiologic mechanisms underlying DKA-related cerebral edema are unclear. A number of past and more recent studies have investigated bio-chemical and therapeutic risk factors for the development of cerebral edema. Recent studies have shown that a higher initial serum urea nitrogen concentration and lower initial partial pressure of carbon dioxide are associated with the development of cerebral edema. This and other information suggests that the pathophysiology of DKA-related cerebral edema may involve cerebral ischemia. Terms and Conditions Privacy statement Information for advertisers Contact us

47. BioMed Central | Full Text | Cerebral Edema In Children With Diabetic Ketoacidos Welcome guest user, http://www.biomedcentral.com/1534-4827/1/41

Welcome guest user home journals A-Z journals by subject advanced search ... my BioMed Central Although all research articles in Current Diabetes Reports are available free, most other articles require a subscription Click here to view an abstract of this article Click here to login if you are already a subscriber to Current Diabetes Reports Subscribe to Current Diabetes Reports Register for a free online trial Ask your librarian to investigate institutional access Athens users please click here to gain access If you believe you are seeing this page in error, or cannot activate your subscription, e-mail us info@biomedcentral.com Terms and Conditions Privacy statement Information for advertisers ... Contact us

48. High-Altitude Cerebral Edema HighAltitude cerebral edema. High-altitude cerebral edema (HACE) isthe medical term for a disorder (theoretically linked to brain http://www.wfubmc.edu/besthealth/ODH/hace.htm

HOME EMERGENCY CARE MINOR MEDICAL CONCERNS MAJOR MEDICAL CONCERNS ... ACTIVITY RELATED CONCERNS High-Altitude Cerebral Edema High-altitude cerebral edema (HACE) is the medical term for a disorder (theoretically linked to brain swelling) that involves an alteration of mental status seen at high altitude, related to diminished atmospheric oxygen. Symptoms include difficulty walking (inability to walk a straight line, staggering, or frank inability to walk), headache (often throbbing), confusion, difficulty in speaking, drowsiness, vomiting, and, in severe cases, blindness, unconsciousness, paralysis, and/or coma. A victim may suffer from HACE and high-altitude pulmonary edema (HAPE) at the same time. Other symptoms may include hallucinations, paralysis of an arm and/or leg, and seizures. Victims are often gray or pale in appearance. Imbalance or the inability to walk heel to toe in a straight line is a very worrisome sign and should prompt immediate action to treat the victim. The treatment for HACE is immediate descent to an altitude below one at which the victim previously had no symptoms, and the

49. Type 1 Diabetes And Sports Participation Predicting cerebral edema during Diabetic Ketoacidosis. Among 6977such children, the authors identified 61 with cerebral edema. http://www.idea2000.org/moreinfo/docs/Cerebral_Edema_during_Ketoacidosis.html

Predicting Cerebral Edema during Diabetic Ketoacidosis The New England Journal of Medicine January 25, 2001 Vol. 344, No. 4 Cerebral edema is a devastating complication of diabetic ketoacidosis and remains the leading cause of serious illness and death in children with diabetes mellitus. (1) The causes of cerebral edema are unknown, largely because of the lack of large-scale population-based studies. However, several hypotheses relating to possible antecedent risk factors and the effects of various treatment regimens have been proposed. (1) In this issue of the Journal, Glaser et al. (2) report the results of a retrospective analysis of cases of children with diabetic ketoacidosis at 10 centers. Among 6977 such children, the authors identified 61 with cerebral edema. The incidence of cerebral edema was 0.9 percent, a rate remarkably similar to that reported historically in the United States (3) and recently in the United Kingdom. (4) As in previous studies, the risk was highest among younger children with newly diagnosed diabetes. (1) The 21 percent mortality rate associated with cerebral edema was similar to that in the United Kingdom, (4) as was the morbidity rate, with a substantial 27 percent of the survivors having neurologic sequelae. The development of cerebral edema may be the result of the treatment that children receive for diabetic ketoacidosis; treatments such as high doses of insulin and the administration of bicarbonate or large volumes of hypotonic fluid would be the major culprits. (1) However, it is also possible that the condition is an idiosyncratic response to diabetic ketoacidosis. Thus far, no adequate proof for either hypothesis has been advanced.

50. Radiology In Ped Emerg Med, Vol 5, Case 6 ventricles. This is the case in generalized cerebral edema, subduralhematoma, epidural hematoma, etc. View compressed ventricles. http://www.hawaii.edu/medicine/pediatrics/pemxray/v5c06.html

Intracranial Hypertension and Brain Herniation Syndromes Radiology Cases in Pediatric Emergency Medicine Volume 5, Case 6 Loren G. Yamamoto, MD, MPH Kapiolani Medical Center For Women And Children University of Hawaii John A. Burns School of Medicine This is a 5-year old female who is brought to the emergency department at 8:00 a.m. because she was poorly responsive when her mother awoke her in the morning. This prompted her mother to drive her to the E.D. There is a history of headache and vomiting during the evening and night. There is no history of trauma. Exam: VS T36.7 (rectal), P92, R32, BP 137/97. She is minimally responsive. Pupils equal and reactive. There are no signs of external trauma. Within minutes of arrival, she exhibits extensor posturing. She is orally intubated using the rapid sequence induction method with atropine, thiopental, and vecuronium. She is hyperventilated. End-tidal CO2 monitoring is used to keep her pCO2 in the 25 mmHg range. A loading dose of phenytoin is administered. An emergency CT scan is ordered. View CT scan. The image on the left is a high CT cut which should show the sulci and gyri well. Due to increased ICP, the cortex is compressed up against the calvarium losing the distinctness of the sulci and gyri. The space between the cortex and the calvarium is obliterated. The sulci/gyri sign cannot be totally relied upon in some instances. In cases of external hydrocephalus or chronic (or subacute) subdural effusions, fluid collects over the cortex. The fluid space between the cortex and the calvarium appears to be increased and the sulci/gyri may appear prominent. View prominent sulci/gyri.

51. Glaser Et Al Commentary on .Glaser N et al. Risk factors for cerebral edema inchildren with diabetic ketoacidosis. NEJM 2001;3442649. Fluid http://www.pediatric-emergency.com/Glasern.htm

Commentary on....Glaser N et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. NEJM 2001;344:264-9. matched with three controls for: age, new or established type I diabetes, venous pH or bicarb at presentation, and serum glucose at presentation. The matched controls were then used to perform a multivariate analysis examining the baseline variables as well as the therapeutic variables and changes in biochemical variables. To the researchers credit, and adding to the strength of the study, three statistical analyses that are frequently missing from other retrospective research were performed. 1) An assessment of interrater agreement was performed to look at the consistency of data extraction from the charts (Kappa = 0.9). 2)To eliminate the possibility that chance was the cause of an association during this large number of comparisons, two procedures were performed to adjust for multiple comparisons between groups (Scheffe and Bonferroni). 3) The multivariate analysis was performed in fashion known to optimize the assessment of variance with small sample sizes. The multivariate analysis identified low partial pressure of CO2 and blood urea nitrogen on presentation to be associated with cerebral edema. While these differences were found to be of statistical significance, there clinical significance is uncertain ( mean pCO2

52. RISK FACTORS FOR CEREBRAL EDEMA IN CHILDREN WITH DIABETIC KETOACIDOSIS RISK FACTORS FOR cerebral edema IN CHILDREN WITH DIABETIC KETOACIDOSIS.Glaser, N. et al. NEJM 2001; 344 264269. BACKGROUND. Cerebral http://www.geocities.com/rcrmced/AbsArt_files/Endo/Cerebral_Edema_DKA.html

RISK FACTORS FOR CEREBRAL EDEMA IN CHILDREN WITH DIABETIC KETOACIDOSIS Glaser, N. et al. NEJM 2001; 344: 264-269. BACKGROUND. Cerebral edema is an uncommon but devastating complication of diabetic ketoacidosis in children. Risk factors for this complication have not been clearly defined. METHODS. In this multicenter study, we identified 61 children who had been hospitalized for diabetic ketoacidosis within a 15-year period and in whom cerebral edema had developed. Two additional groups of children with diabetic ketoacidosis but without cerebral edema were also identified: 181 randomly selected children and 174 children matched to those in the cerebral-edema group with respect to age at presentation, onset of diabetes (established vs. newly diagnosed disease), initial serum glucose concentration, and initial venous pH. Using logistic regression, we compared the three groups with respect to demographic characteristics and biochemical variables at presentation and compared the matched groups with respect to therapeutic interventions and changes in biochemical values during treatment. CONCLUSIONS. Children with diabetic ketoacidosis who have low partial pressures of arterial carbon dioxide and high serum urea nitrogen concentrations at presentation and who are treated with bicarbonate are at increased risk for cerebral edema.

53. April | Hot Topics In Healthcare cerebral edema With Pediatric Diabetic Ketoacidosis Who Is at Risk? Riskfactors for cerebral edema in children with diabetic ketoacidosis. http://www.ahcpub.com/ahc_root_html/hot/archive/ema042001.html

Trouble navigating this site? Please try our Site Map Return to Hot Topics Index Cerebral Edema With Pediatric Diabetic Ketoacidosis: Who Is at Risk? From Emergency Medicine Alert Source : Glaser N, et al. Risk factors for cerebral edema in children with diabetic ketoacidosis. N Engl J Med Data from each child’s medical record were collected including demographics, serum chemistry results, treatment regimen, and changes in laboratory values during treatment. Comparison of the children with CE to the children in the random control group demonstrated that CE was significantly associated with lower initial pCO2 (relative risk for each decrease of 7.8 mmHg was 3.4; 95% CI 1.9-6.3) and higher initial blood urea nitrogen (BUN) (relative risk for each increase of 9 mg/dL was 1.7; 95% CI 1.2-2.5). Comparison of the children with CE to the matched control group also showed that CE was associated with lower initial pCO2 and higher initial BUN. Examination of therapeutic variables revealed that after adjustment for other covariates, treatment with bicarbonate was associated with an increased risk of CE (relative risk, 4.2; 95% CI 1.5-12.1). Smaller increases in the serum sodium concentration during therapy also were associated with CE. Interestingly, the rates of fluid or sodium administration were not associated with an increased risk of CE after adjustment for covariates. Comment by Jacob W. Ufberg, MD

54. Cerebral Edema cerebral edema Swelling in the brain due to an increase in its water content. http://www.finr.com/casestudies/def_phsyc/def_neuro/Verbal_agress/innapp_social/

Cerebral edema- Swelling in the brain due to an increase in its water content.

55. Cerebral Edema First Previous Next Last Index Home Text. Slide 38 of 63. http://www2.austin.cc.tx.us/barnes/head/sld038.htm

56. Cerebral Edema cerebral edema. Swelling of the brain itself with or without associated bleeding. diffusecerebral edema may also occur in hypoxic insult to the brain. Ischemia. http://www2.austin.cc.tx.us/barnes/head/tsld038.htm

Cerebral Edema Swelling of the brain itself with or without associated bleeding Results from humoral and metabolic responses to injury leads to marked increases in ICP diffuse cerebral edema may also occur in hypoxic insult to the brain Ischemia caused by vascular injury or ICP, may lead to more focal or global infarcts Previous slide Next slide Back to first slide View graphic version

57. Prevention Of Cerebral Edema And Infarct In Cerebral Reperfusion Injury By An An Prevention of cerebral edema and Infarct in CerebralReperfusion Injury by an Antibody to Interleukin8. http://info.med.yale.edu/labinvest/abstracts/97months/9708aug/0897005.html

The United States and Canadian Academy of Pathology Lippincott Williams and Wilkins publishes Laboratory Investigation View Future Titles Through Mar 2001 Archives Aug 1965 - Feb 2001 ... Aug 1965 - Feb 2001 Prevention of Cerebral Edema and Infarct in Cerebral Reperfusion Injury by an Antibody to Interleukin-8 Tetsuya Matsumoto, Kiyonobu Ikeda, Naofumi Mukaida, Akihisa Harada, Yoshihiro Matsumoto, Junkoh Yamashita, and Kouji Matsushima Department of Neurosurgery (TM, KI, JY), School of Medicine, and Department of Pharmacology (TM, NM, AH, KM), Cancer Research Institute, Kanazawa University, Kanazawa; Fuji Gotemba Research Labs (YM), Chugai Pharmaceutical Company Ltd., Gotemba; and Department of Molecular Preventive Medicine (KM), School of Medicine, University of Tokyo, Tokyo, Japan

58. COMMON TREATMENT FOR DIABETIC CRISIS IN CHILDREN MAY CONTRIBUTE TO RARE BUT OFTE diabetic crisis should be abandoned in most cases because it appears to contributeto a rare but oftenfatal complication known as cerebral edema, according to http://news.ucdmc.ucdavis.edu/diabetes_study.html

FOR IMMEDIATE RELEASE: January 24, 2001 CONTACT Carole F. Gan Pager: (916) 762-2089 COMMON TREATMENT FOR DIABETIC CRISIS IN CHILDREN MAY CONTRIBUTE TO RARE BUT OFTEN FATAL COMPLICATION (Sacramento, Calif.) - A common treatment for children in diabetic crisis should be abandoned in most cases because it appears to contribute to a rare but often-fatal complication known as cerebral edema, according to a study by researchers at UC Davis School of Medicine and Medical Center. The study also identifies two simple blood test measurements that can help doctors predict which patients are in greatest danger of developing the potentially deadly complication. The study, the largest and most statistically rigorous examination yet of risk factors for cerebral edema in children with diabetic ketoacidosis, appears in the Jan. 25 issue of the New England Journal of Medicine. The researchers found that bicarbonate, a common treatment for diabetic ketoacidosis, appears to increase the risk of cerebral edema, or swelling of the brain, which can be fatal. In ketoacidosis, toxic levels of acids called ketones build up in the blood. Bicarbonate is often given in the emergency department to reduce these acid levels. "In the past there has been some suspicion that giving bicarbonate can increase risk of cerebral edema, but ours is the first study to show that it can," said Nathan Kuppermann, senior author of the study, a pediatric emergency physician and associate professor of internal medicine at UC Davis. "I imagine doctors in emergency departments and pediatric intensive care units will put this knowledge into effect immediately."

59. CyberSpace Search! SEARCH THE WEB. Results 1 through 1 of 1 for cerebral edema. Cerebraledema Paralisis cerebral Aneurisma cerebral Cerebral dysesthesia http://www.cyberspace.com/cgi-bin/cs_search.cgi?Terms=cerebral edema

60. MEDLINEplus Medical Encyclopedia: Acute Mountain Sickness Alternative names Return to top High altitude cerebral edema; Altitude anoxia;Altitude sickness; Mountain sickness; High altitude pulmonary edema. http://www.nlm.nih.gov/medlineplus/ency/article/000133.htm

Skip navigation Medical Encyclopedia Other encyclopedia topics: A-Ag Ah-Ap Aq-Az B-Bk ... Z Acute mountain sickness Contents of this page: Illustrations Alternative names Definition Causes, incidence, and risk factors ... Prevention Illustrations Respiratory system Alternative names Return to top High altitude cerebral edema; Altitude anoxia; Altitude sickness; Mountain sickness; High altitude pulmonary edema Definition Return to top Acute mountain sickness is an illness that can affect mountain climbers, hikers, skiers, or travelers who ascend too rapidly to high altitude (typically above 8,000 feet or 2,400 meters). This is especially for persons who normally reside at or near sea level. Causes, incidence, and risk factors Return to top Reduced atmospheric pressure and a lower concentration of oxygen at high altitude are the causes of this illness. It affects the nervous system, lungs, muscles, and heart. Symptoms can range from mild to life-threatening. In most cases the symptoms are mild, but in severe cases fluid collects in the lungs ( pulmonary edema ) causing extreme shortness of breath and further decreasing oxygenation.

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