Author/Editor		Bajrović, Fajko F
Title		Patofiziologija možganske oblike akutne višinske bolezni. Pregled literature
Translated title		Pathophysiology of cerebral syndrome in high altitude illness. Literature review
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 41, št. 2-3
Publication year		2002
Volume		str. 163-8
Language		slo
Abstract		Acute mountain sickness and high altitude cerebral edema are related neurological disorders that strike unacclimatized persons on fast ascent to high altitude. While the clinical aspects of diagnosis and treatment of a cerebral syndrome are well established, their pathophysiology remains elusive. Recent studies show that the exposure to hypobaric hypoxia during fast ascent to high altitude enhances development of cerebral vasogenic edema before the onset of symptoms and signs of acute mountain sickness. Reasons for increasesd blood-brain barrier permeability might include mechanical factors (loss of autoregulation and increased capillary pressure), ischaemia, neurogenic influences and biochemical mediators. In the advanced stages of the disease, vasogenic edema is probably accompanied by cytotoxic edema. Acute mountain sickness and clinical entity "cerebral edema" are considered two clinical ends of the cerebral syndrome in high altitude illness with the same pathophysiological background. Symptoms of cerebral syndrome in high altitude illness are related to increased intracranial pressure. It seems that the evolution of symptoms depends on the compliance of the craniospinalspace.
Summary		Akutna višinska slabost in možganski edem sta možganski obliki akutne višinske bolezni, ki lahko prizadaneta neaklimatizirane osebe med hitrim vzponom na veliko nadmorsko višino. Kljub dobro znani klinični sliki in razmeroma učinkovitem zdravljenju, patofiziološka podlaga za možgansko obliko akutne višinske bolezni ni znana. Novejše raziskave kažejo, da se v razmerah hipobarične hipoksije med hitrim vzponom na visoko nadmorsko višino v možganih razvija vazogeni edem že pred razvojem simptomov in znakov akutne višinske slabosti. Vzroki za povečano prepustnost hematoencefalne pregrade bi lahko bili mehanični dejavniki (izguba avtoregulacije in povišan kapilarni tlak), ishemija, nevrogeni vplivi in biokemični mediatorji. Vazogenemu edemu se ob napredovanju bolezni verjetno pridruži tudi citotoksičen edem. Vse bolj je sprejeto mnenje, da sta akutna višinska slabost in klinična entiteta "možganski edem" le različni stopnji možganske oblike višinske bolezni z isto patofiziološko podlago. Simptomi, ki nastopijo ob možganski obliki akutne višinske bolezni so posledica povečanega intrakranialnega tlaka. Zdi se, da je razvoj simptomov odvisen od podajnosti kraniospinalnega prostora.
Descriptors		ALTITUDE SICKNESS BRAIN EDEMA