Cerebral Venous Sinus Thrombosis at High Altitude

Shrestha, Promish; Basnyat, Buddha; Küpper, Thomas; Giet, Simone van der

doi:10.1089/ham.2011.1043

Cited by 11 publications

(6 citation statements)

References 10 publications

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“…Fujimaki et al had described a similar case in 1986 and, interestingly, the patient was in Nepal and had climbed 3161 meters on the way to Everest [3]. Various hereditary thrombophilic conditions like protein C deficiency and Factor V Leiden mutation leading to CVST in a high altitude climber have been reported [20]. The history and clinical and investigation findings suggest a multifactorial etiology of CVST in our case.…”

Section: Discussionsupporting

confidence: 51%

Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Khanal

Thapa

Shrestha

et al. 2016

Case Reports in Neurological Medicine

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Cerebral venous sinus thrombosis (CVST) is a rare but serious disorder that is associated with a poor clinical outcome. We report a 35-year-old man who had a severe headache and diplopia while climbing Mount Everest. His MR venography showed right transverse and right sigmoid sinus thrombosis. He improved on anticoagulant and symptomatic measures. Cerebral venous sinus thrombosis at high altitude is discussed.

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Section: Discussionsupporting

confidence: 51%

Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Khanal

Thapa

Shrestha

et al. 2016

Case Reports in Neurological Medicine

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“… 74 - 76 Familial thrombophilia (protein S or C deficiency, heterozygous Factor V Leiden mutation) was identified as the cause of few CVT case reports occurred between 3000 and 8848 m asl. 66 , 77 - 79 …”

Section: Literature and Research Methodsmentioning

confidence: 99%

Recommendations for traveling to altitude with neurological disorders

Falla

Giardini²,

Angelini

2021

J Cent Nerv Syst Dis

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Background Several neurological conditions might worsen with the exposure to high altitude (HA). The aim of this review was to summarize the available knowledge on the neurological HA illnesses and the risk for people with neurological disorders to attend HA locations. Methods A search of literature was conducted for several neurological disorders in PubMed and other databases since 1970. The neurological conditions searched were migraine, different cerebrovascular disease, intracranial space occupying mass, multiple sclerosis, peripheral neuropathies, neuromuscular disorders, epileptic seizures, delirium, dementia, and Parkinson’s disease (PD). Results Attempts were made to classify the risk posed by each condition and to provide recommendations regarding medical evaluation and advice for or against traveling to altitude. Individual cases should be advised after careful examination and risk evaluation performed either in an outpatient mountain medicine service or by a physician with knowledge of HA risks. Preliminary diagnostic methods and anticipation of neurological complications are needed. Conclusions Our recommendations suggest absolute contraindications to HA exposure for the following neurological conditions: (1) Unstable conditions–such as recent strokes, (2) Diabetic neuropathy, (3) Transient ischemic attack in the last month, (4) Brain tumors, and 5. Neuromuscular disorders with a decrease of forced vital capacity >60%. We consider the following relative contraindications where decision has to be made case by case: (1) Epilepsy based on recurrence of seizure and stabilization with the therapy, (2) PD (± obstructive sleep apnea syndrome-OSAS), (3) Mild Cognitive Impairment (± OSAS), and (4) Patent foramen ovale and migraine have to be considered risk factors for acute mountain sickness.

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“…This study represented similar group of patients exposed to HA as in this study but frequency of Cerebral venous thrombosis was not mentioned in the study. per million in general population 13,14 . It remains a challenging diagnosis due to variety of clinical presentations and diagnosis is often delayed.…”

Section: Discussionmentioning

confidence: 99%

High Altitude and Venous Thrombosis: Frequency and Risk Factors

Choudry

Iftikhar

Qadir

et al. 2021

PAFMJ

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Objective: To determine the effect of high altitude on frequency and risk factors of venous thrombosis inindividuals ascending to high altitude Study Design: Cross-sectional analytical study. Place and Duration of Study: Armed Forces Bone Marrow Transplant Centre, Combined Military HospitalSkardu, from Apr 2015 to Aug 2018. Methodology: High Altitude was taken as height equal to or more than 8000 feet. Polycythemia as hemoglobin>16.5 g/dl OR hematocrit >49%. Medical records of all patients evacuated from high altitude through CombinedMilitary Hospital Skardu were analyzed retrospectively. A proforma was designed to include necessary variables. Results: We evaluated medical records of 539 individuals and found frequency of 86 (15.9%) for venous thromboembolism (VTE) at high altitude. Cerebral venous sinus thrombosis (CVST) was most common thrombotic complication seen in 39 patients (46%). Majority of thrombotic episodes occurred at >18000 feet (likelihood ratio (LR) 5.99, p-value 0.009). Majority of thrombotic episodes 34 (39%) occurred within first 45 days of ascent to high altitude. Thrombosis was linked to smoking 47 (55%) (likelihood ratio 21.3 and p-value <0.001) and use of melted snow as a source of drinking water 56 (65%) (likelihood ratio 57.6 and p-value <0.001). Conclusion: This study showed a very high frequency of thrombotic complications at high altitude. There isa need for a robust prospective study covering epidemiology, clinical information and diagnostics in order todevelop appropriate standard operating procedures and guidelines for prevention of thrombosis at HA

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Cerebral Venous Sinus Thrombosis at High Altitude

Cited by 11 publications

References 10 publications

Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Cerebral Venous Sinus Thrombosis during Everest Expedition: A Case Report and Review of the Literature

Recommendations for traveling to altitude with neurological disorders

High Altitude and Venous Thrombosis: Frequency and Risk Factors

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