High-altitude stroke

High urgency
-Very severe

As in stroke, it corresponds to the lack of blood supply and oxygenation of a group of neurons in the brain.  

It is due to the obstruction of cerebral circulation by a blood clot. The formation of the clot at an altitude of 3000m is favoured by an increase in blood viscosity. The blood thickens due to an increase in red blood cells, dehydration and lack of oxygen in the blood.

Dizziness, headache, impaired vision, impaired speech, and impaired strength or sensation appear suddenly.

The diagnosis is clinical and it is characteristic that the symptoms improve when descending in altitude and breathing oxygen.

It is considered a life-threatening emergency and requires immediate descent and oxygen therapy.

Bibliographic references
  1. Scott A Gallagher, MD. Peter Hackett, MD. Jonathan M Rosen, MD. High altitude illness: Physiology, risk factors, and general prevention. UpToDate, Apr 15, 2015.
  2. Scott A Gallagher, MD. Peter Hackett, MD. Acute mountain sickness and high altitude cerebral edema. UpToDate. Mar 03, 2016.
  3. West JB, American College of Physicians, American Physiological Society. The physiologic basis of high-altitude diseases. Ann Intern Med 2004; 141:789.
  4. Schoene RB. Illnesses at high altitude. Chest 2008; 134:402.
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Neurological symptoms: impaired speech, physical strength or feeling


    Pulse oximeter saturation below 80%


    Change in mood and/or behaviour


    Hallucinations


    Diminished level of consciousness

Pre-hospital care recommendations

Descend below clearance height (< 2.500 metres).
Maintain hydration of 2 litres per day.