Cerebrovascular dynamics and vascular endothelial growth factor in acute mountain sickness

Joseph Palma, Christian Macedonia, Patricia Deuster, Cara Olsen, B. Robert Mozayeni, Kevin E. Crutchfield*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Objective. - To determine if serum vascular endothelial growth factor (VEGF) and ultrasonic monitoring of vascular dynamics with dynamic vascular analysis at sea level and high altitude correlate with acute mountain sickness symptoms. Methods.-Nine volunteers participated in a staged ascent from sea level to 4300 m undergoing complete transcranial Doppler studies with dynamic vascular analysis. Serum VEGF levels, Lake Louise scores, Spielberger-1 scores, Subjective Exercise Experiences Scale positive scores, and Symptom Checklist-90 surveys were collected after 24 hours at each altitude. Results. - Symptom scores, index of pulsatility, and dynamic flow index differentiated the subjects into 2 distinct groups. Symptomatic subjects had increased VEGF levels at sea level but decreased levels at 4300 m. The dynamic flow index increased in symptomatic subjects at 4300 m compared with the asymptomatic subjects. The mean flow velocity increased in both groups and could not be used to differentiate the subjects. Conclusions. - Altered vascular physiology is associated with acute mountain sickness. Increased vascular permeability increases vascular capacitance, with an increase in dynamic flow index to meet these demands. Altered vascular dynamics were associated with high-altitude cerebral edema in 1 subject. Dynamic vascular analysis demonstrated altered vascular pathophysiology associated with acute mountain sickness. Changes in VEGF were meaningful when interpreted with the dynamic vascular analysis findings. These physiological findings may help explain the vascular changes associated with hypocarbic hypoxemia at altitude.

Original languageEnglish
Pages (from-to)1-7
Number of pages7
JournalWilderness and Environmental Medicine
Issue number1
StatePublished - 2006
Externally publishedYes


  • Acute mountain sickness
  • Altitude
  • Blood brain barrier
  • Dynamic vascular analysis
  • Endothelial dysfunction
  • Transcranial Doppler ultrasound
  • Vascular endothelial growth factor


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