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Case report
Sudden onset hemiplegia at high altitude
  1. Henry C Chandler1 and
  2. A Mellor2,3
  1. 1York Garrison Medical Centre, Imphal Barracks, York, UK
  2. 2Department of Cardiothoracic Anaesthesia, James Cook University Hospital, Middlesbrough, UK
  3. 3Academic Department of Anaesthesia and Critical Care Medicine, RCDM, Birmingham, UK
  1. Correspondence to Capt Henry C Chandler, RMO 2 Signal Regiment, Medical Centre, Imphal Barracks, York YO10 4HD, UK; henrychandler{at}doctors.org.uk

Abstract

Travel to high altitude and the incumbent exposure to hypobaric hypoxia leads to a prothrombotic state. This may increase the likelihood of thromboembolic events, including stroke, in otherwise healthy individuals. While there have been sporadic anecdotal reports of ‘stroke-like’ syndromes at high altitude for over 100 years, there are surprisingly few detailed reports supported by imaging.

This report describes a case of posterior circulation infarct thought to be due to a paradoxical embolus through a patent foramen ovale. The relationship between high-altitude physiology, increased incidence of thromboembolism and the significance of patent foramen are discussed in the report.

  • ALTITUDE MEDICINE

https://doi.org/10.1136/jramc-2014-000372

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    Footnotes

    • Contributors HCC was involved in actively managing the patient with telephone advice from AM. HCC and AM prepared the manuscript. HCC was responsible for submitting the paper.

    • Competing interests None.

    • Provenance and peer review Not commissioned; externally peer reviewed.