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High-altitude cerebral oedema — DipIMC MCQ

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HardEnvironmental MedicineHigh-altitude cerebral oedemaDipIMC

A 32-year-old hiker at altitude has headache, ataxia and confusion. He is breathless at rest and has been ascending rapidly over two days. What is the most appropriate immediate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Stop ascent, give oxygen if available and arrange urgent descent or evacuation

Ataxia and confusion at altitude suggest high-altitude cerebral oedema, a life-threatening condition requiring descent, oxygen and evacuation. Continuing ascent or exertion worsens hypoxic stress. Migraine should not be assumed when neurological signs are present. The pearl is that ataxia at altitude is a red flag requiring immediate descent.

Reference: JRCALC Guidelines 2025; UIAA/UK altitude illness guidance