Are you planning to hike in high altitudes? If so, it’s important to be aware of the risks associated with this activity. High altitude cerebral edema (HACE) is a potentially life-threatening condition that can occur when hiking at very high altitudes.

In this blog post, we’ll discuss HACE prevention and treatment options so you can make an informed decision about your next outdoor adventure.

Understand the Symptoms of HACE

High-altitude cerebral edema (HACE) is a potentially life-threatening condition that develops in high-altitude environments. It is characterized by fluid accumulation in the brain, which can cause confusion, clumsiness, and stumbling.

It is important to be aware of the signs and symptoms of HACE so that you can seek immediate medical attention.

Some common signs and symptoms of HACE include headache, nausea, dizziness, fatigue, loss of coordination, difficulty speaking, rapid pulse, and difficulty breathing. If you experience any of these symptoms, it is important to seek medical attention immediately.

How Can You Treat High Altitude Cerebral Edema (HACE)?

High-altitude cerebral edema (HACE) is a serious, life-threatening form of altitude sickness that requires immediate medical attention.

1. Descent as a First Aid Treatment for HACE

Descending to a lower altitude is the first aid treatment for acute mountain sickness (AMS), high altitude pulmonary edema (HAPE), and high altitude cerebral edema (HACE). If you experience symptoms of AMS, you should immediately descend 500-1000 feet and rest.

Depending on the severity of the symptoms, you may have to descend even further.

For HAPE, the descent of at least 1000-2000 feet is recommended; for HACE, the descent of at least 2000-3000 feet is recommended.

The lower the elevation, the better the chance of recovery. Research has shown that descending even 500 feet can be beneficial in alleviating symptoms of AMS.

However, if the symptoms are not improve or worsen, descent should be continued until there is an improvement. Once the symptoms have subsided, it is advised that you stay at the lower elevation for a day or two before attempting to ascend again. It is important to rest and take it slow when ascending to allow your body time to acclimate to the new altitude.

2. Acclimatizing Safely to High Altitudes

Acclimatizing safely to high altitudes is the best way to prevent altitude sickness. It is important to take the time to acclimatize properly when ascending to higher altitudes. This means planning for rest days and pacing yourself as you ascend.

You should avoid ascending more than 1,000 feet per day, and for every 3,000 feet of ascent, it is recommended that you take a rest day. Additionally, it is important to watch for signs of altitude sickness and descend immediately if any symptoms arise. If symptoms become severe or you cannot descend on your own, seek medical assistance.

3. Avoid Becoming Dehydrated

It is important to take measures to prevent dehydration while at high altitudes. Make sure to drink plenty of fluids and avoid any extreme physical activity. You should also be aware of the signs of dehydration, such as thirst, fatigue, and dizziness, and adjust your fluid intake accordingly.

3. Managing the Symptoms Without Medical Intervention

Altitude sickness affects people differently, and not everyone needs medical intervention. If your symptoms are mild, you can manage them without medical intervention. It is important to remember that with any altitude sickness, the most important part of treatment involves descending to a lower altitude as soon as possible.

Rest is a key factor in recovery when attempting to manage symptoms without medical intervention. Make sure you get plenty of rest and avoid any strenuous activities. Drink plenty of fluids and avoid alcohol and smoking. Eating light meals can also help reduce symptoms. Over-the-counter medications such as ibuprofen, acetaminophen, and anti-nausea medications can also help relieve symptoms.

If your symptoms persist or worsen after a few days, it is important to seek professional medical help. The longer you stay at a high altitude without descending, the more likely your symptoms will worsen and become dangerous.

Hiker woman with trekking sticks climbs steep on mountain trail, focus on boot

4. Medications Used to Treat or Prevent AMS

When treating high altitude cerebral edema (HACE), medications are an important part of the treatment plan. Acetazolamide is often prescribed to reduce swelling in the brain and improve symptoms.

Ibuprofen may be recommended for those with a history of AMS or milder forms of HACE. It’s important to take medications as prescribed and follow up with your doctor for further guidance.

Dexamethasone (Decadron®) is a prescription steroid medication that may also be used to reduce swelling in the brain and improve symptoms, but it is generally reserved for severe cases of HACE.

It is generally reserved for more severe cases of HACE and can be administered as an injection or intravenously. Acetazolamide prophylaxis may also be prescribed to prevent mountain sickness or HACE in at-risk people. It is important to follow the doctor’s instructions carefully when taking medications and to be aware of potential side effects.

5. Oxygen Therapy for HAPE and HACE

Oxygen therapy is often used to treat high-altitude pulmonary edema (HAPE) and high-altitude cerebral edema (HACE). This therapy involves using a portable oxygen tank to provide supplemental oxygen to those suffering from these conditions.

It is important to note that the amount of oxygen used in oxygen therapy should be carefully monitored, as too much oxygen can be dangerous. The effects of oxygen therapy can be seen within minutes or hours, depending on the severity of the condition. Oxygen therapy helps reduce the symptoms of HAPE and HACE, and it can often lead to a full recovery if administered in time.

6. Consider Hyperbaric Oxygen Treatment

Hyperbaric oxygen therapy is an effective treatment for high-altitude cerebral edema (HACE), as it increases the amount of oxygen in the blood and helps to reduce brain swelling. This treatment is usually administered in a hyperbaric chamber, where the air pressure is higher than normal.

This increase in air pressure helps to force more oxygen into the bloodstream, which can help to reduce brain swelling and improve symptoms. However, it is important to note that hyperbaric oxygen therapy should only be administered under the supervision of a doctor.

It is important to note that oxygen therapy is not a replacement for medications or descent but rather a supportive measure that can help to improve symptoms. Additionally, hyperbaric oxygen treatment may be considered if oxygen therapy alone is insufficient.

7. Reduce Physical Activity Levels

When suffering from HACE, it is important to reduce physical activity levels. This can help reduce the strain on the body, which can benefit those with HACE. It is also important to rest and get plenty of sleep to help the body heal. It is also important to stay warm and comfortable in bed or chair while limiting physical activity levels.

8. Reduce Stress and Anxiety Levels

Resting in a calm environment and engaging in relaxation techniques such as deep breathing, yoga, or meditation can help lower stress levels. Avoiding strenuous physical activity and getting plenty of quality sleep can also help.

If possible, maintain a positive attitude and outlook, as this can often help in the healing process. Talk to a mental health professional about managing your stress and anxiety levels. Relaxation techniques such as yoga, deep breathing, and mindful meditation can help manage stress levels.

9. Eat Small, Regular Meals Throughout the Day

Eating small, regular meals throughout the day is also recommended for those suffering from HACE. Eating smaller meals helps to ensure that your body receives enough food and energy while not overworking your digestive system. This will help you maintain your energy levels and reduce stress and fatigue.

10. Stay Warm and Comfortable in Bed or Chair

Staying warm and comfortable in bed or a chair is important in treating high-altitude cerebral edema (HACE). During recovery, it’s important to avoid becoming too cold or overheated.

This can be accomplished by wearing layers of clothing, using blankets, and keeping the room temperature comfortable. Additionally, adjusting the room’s airflow can help regulate the temperature.

11. Be Aware of Potential Complications

If a person with HACE is not given proper medical attention, it can lead to severe complications. These complications can include brain damage, coma, respiratory failure, or even death.

It is important to be aware of the potential complications associated with HACE and seek medical help as soon as possible. If a person is experiencing any of the symptoms of HACE, they should immediately seek medical attention and take all necessary precautions to prevent further complications.


High Altitude Cerebral Edema (HACE) is a serious medical condition that requires immediate medical attention. It is important to be aware of the potential symptoms of HACE and to seek medical attention if you experience any of them.

Treatment for HACE includes medication, oxygen therapy, hyperbaric oxygen treatment, and corticosteroids as needed. It is also important to reduce physical activity levels, stay warm and comfortable, and reduce stress and anxiety while recovering. Following up with your doctor is essential for ongoing guidance and support.