High-Altitude Cerebral Edema in a Non-climber at the K2 Base Camp: A Case Report

A 47-year-old male base camp team member at the K2 Base Camp (5150 m) developed headache, dizziness, unsteady gait, intermittent diplopia, and mild confusion a few days after arrival. His vital signs were respiratory rate 20 breaths per minute, heart rate 112 beats per minute, blood pressure 130/85 mmHg, and oxygen saturation 87% on room air. Neurological examination revealed truncal ataxia and disorientation without focal deficits. In the resource-limited expedition setting, a clinical diagnosis of high-altitude cerebral edema (HACE) was made. The patient was treated with high-flow oxygen and dexamethasone 8 mg intramuscularly, followed by 4 mg every six hours (administered orally during descent), along with acetazolamide 250 mg twice daily and hydration. Helicopter evacuation was impossible for several days due to poor weather, and as the only doctor on site, the clinician arranged descent by mule with accompanying team members. Two days later, communication from a lower altitude confirmed full recovery. This case describes the presentation and successful field management of HACE in a non-climber working at an extreme altitude.