ABSTRACT
Acute mountain sickness (AMS) and high-altitude cerebral edema (HACE) are illnesses caused by rapid ascent to high altitudes. Early reports of symptoms of AMS date back to Chinese travelers crossing the Great and Little Headache Mountains (32 bc). A vivid description of AMS was given in 1604 by a Spanish priest, Father Acosta, traveling in the Peruvian Andes (1). In 1913 Ravenhill (2) characterized three forms of illnesses associated with acute exposure to high altitude. He distinguished between puna, the word used in the Andes for an illness caused by acute exposure to high altitude, of the (1) normal type, with headache, insomnia, vomiting, and lassitude, (2) nervous type, which he considered a ‘‘rare’’ divergence from the normal with ataxia and decreased consciousness, and (3) cardiac type with raˆles and severe dyspnea, which he attributed to heart failure. Today we refer to these three types of puna as AMS, HACE, and high-altitude pulmonary edema (HAPE). In this chapter we will discuss AMS and HACE. AMS is a benign, self-limiting illness, which may, however, progress to HACE, a severe life-threatening illness with distinct neurological impairment.
