Central Neuroendocrine Regulation of Brain Water Permeability

Raichle, Marcus E.; Grubb, Robert L.; Eichling, John O.

doi:10.1002/9780470720370.ch12

Cited by 8 publications

(1 citation statement)

References 31 publications

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“…The leading theory is that HACE is a vasogenic edema (Basnyat and Murdoch, 2003;Hackett and Roach, 2004;Van Osta et al, 2005), due to raised intracranial pressure concomitant to increased permeability of the blood-brain barrier. Experimental studies have demonstrated that stimulation of central noradrenergic output increases such permeability (Raichle et al, 1978); raised sympathetic activity has been documented in humans at high altitude (Reeves, 1993), in particular in individuals suffering from AMS (Lanfranchi et al, 2005). Moreover blood-brain barrier permeability may be increased by several chemical mediators, including iNOS-generated nitric oxide.…”

Section: Discussionmentioning

confidence: 97%

Severe Acute Mountain Sickness and Suspected High Altitude Cerebral Edema Related to Nitroglycerin Use

Mazzuero

Pascariello

2008

High Altitude Medicine & Biology

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An elite mountaineer reported severe acute mountain sickness and ataxia during an 8000-m expedition and concomitant use of transdermal nitroglycerin patches aimed to prevent frostbites. Use of nitroglycerin for this purpose is off-label, and its safety has not been assessed. Moreover, a relation between nitrate-induced cerebral vasodilation and high altitude cerebral edema is theoretically possible on a pathophysiological basis. It is our opinion that nitroglycerin use at high altitude should be discouraged, as efficacy in the prevention of frostbites is questionable and safety has not been assessed.

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