1. ¹Department of Neuroradiology, University Medical Center, Georg-August University, Göttingen, Germany
2. ²MR-Research in Neurology and Psychiatry, University Medical Center, Georg-August University, Göttingen, Germany
3. ³Division of Sports Medicine, Department of Internal Medicine, University Medical Center, Ruprecht-Karls University, Heidelberg, Germany
4. ⁴Department of Neuroradiology, University Medical Centre, Friedrich-Alexander University, Erlangen, Germany
5. ⁵Department of Neurology, University Medical Centre, Friedrich-Alexander University, Erlangen, Germany
6. ⁶Department of Physiology, Hypoxia Research Unit, University of Glamorgan, Pontypridd, South Wales, UK

Correspondence: Professor M Knauth, Department of Neuroradiology, University Medical Center, Robert-Koch-Str. 40, Göttingen D-37099, Germany. E-mail: michael.knauth@med.uni-goettingen.de

⁷These authors contributed equally to this work.

Received 2 February 2008; Revised 19 April 2008; Accepted 21 April 2008; Published online 4 June 2008.

Abstract

Vasogenic edema in the corpus callosum is a characteristic finding in high-altitude cerebral edema (HACE). Furthermore, microhemorrhages have been found at autopsies in brains of HACE victims. The objective of this study was to determine if microhemorrhages also occur in nonlethal HACE. Consequently, magnetic resonance imaging (MRI) was performed in patients who had suffered from HACE and in patients who had suffered from severe acute mountain sickness (AMS) by applying imaging techniques highly susceptible to blood or blood remnants. Two experienced neuroradiologists independently evaluated the exams blinded to clinical data. The MRI was performed 2 to 31 months after the event. The MRI of the HACE patients revealed multiple hemosiderin depositions in the brain—predominantly found in the corpus callosum—indicative of microhemorrhages. These changes were not present in the three AMS patients. In summary, hemosiderin deposits detectable by MRI predominantly in the corpus callosum indicate that microhemorrhages occur in nonlethal HACE, which may serve as a novel diagnostic MRI sign for HACE even many months after the event.