High Altitude Cerebral Edema with concomittent rhabdomyolysis: A rare presentation

We report the case of a young gentleman who developed High Altitude Cerebral Edema (HACE) along with rhabdomyolysis whilst on a trip to the northern areas of Pakistan. High Altitude Cerebral Edema (HACE) represents a serious and potentially fatal type of Acute Mountain sickness (AMS). Rhabdomyolysis presenting with HACE is uncommon however cases have been reported. In our patient, clinical presentation with severe bilateral lower limb pain and difficulty walking along with the increased agitation and confusion made it difficult to recognize; however early descent and management allowed for good recovery. MRI findings with microhemorrhages as found in our patient are increasingly being recognized in HACE with improving sensitivity of available imaging modalities. This case highlights the diverse clinical presentations that can exist with HACE and hence the need for medical professionals to maintain a high index of suspicion in anyone with a recent ascent to high altitude regions who develop neurological manifestations.