{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T06:13:18Z","timestamp":1773295998006,"version":"3.50.1"},"reference-count":12,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J R Army Med Corps"],"accepted":{"date-parts":[[2015,1,19]]},"published-print":{"date-parts":[[2016,12]]},"abstract":"<jats:p>Travel to high altitude and the incumbent exposure to hypobaric hypoxia leads to a prothrombotic state. This may increase the likelihood of thromboembolic events, including stroke, in otherwise healthy individuals. While there have been sporadic anecdotal reports of \u2018stroke-like\u2019 syndromes at high altitude for over 100\u2005years, there are surprisingly few detailed reports supported by imaging.<\/jats:p>\n               <jats:p>This report describes a case of posterior circulation infarct thought to be due to a paradoxical embolus through a patent foramen ovale. The relationship between high-altitude physiology, increased incidence of thromboembolism and the significance of patent foramen are discussed in the report.<\/jats:p>","DOI":"10.1136\/jramc-2014-000372","type":"journal-article","created":{"date-parts":[[2015,2,16]],"date-time":"2015-02-16T22:51:55Z","timestamp":1424127115000},"page":"470-472","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Sudden onset hemiplegia at high altitude"],"prefix":"10.1136","volume":"162","author":[{"given":"Henry C","family":"Chandler","sequence":"first","affiliation":[{"name":"York Garrison Medical Centre, Imphal Barracks, York, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A","family":"Mellor","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Anaesthesia, James Cook University Hospital, Middlesbrough, UK"},{"name":"Academic Department of Anaesthesia and Critical Care Medicine, RCDM, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,2,16]]},"reference":[{"key":"2025081307064780000_162.6.470.1","doi-asserted-by":"crossref","first-page":"pii:bcr2013201897","DOI":"10.1136\/bcr-2013-201897","article-title":"High-altitude cerebral oedema mimicking stroke","volume":"2014","author":"Yanamandra","year":"2014","journal-title":"BMJ Case Rep"},{"key":"2025081307064780000_162.6.470.2","doi-asserted-by":"publisher","DOI":"10.1089\/152702902753639513"},{"key":"2025081307064780000_162.6.470.3","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.26.4.562"},{"key":"2025081307064780000_162.6.470.4","first-page":"173","article-title":"Risk factors of stroke at high and low altitude areas in Saudi Arabia","volume":"29","author":"Al Tahan","year":"1998","journal-title":"Arch Med Res"},{"key":"2025081307064780000_162.6.470.5","first-page":"1","article-title":"Stroke in populations located at high altitudes: review and analysis of risk factors","volume":"17","author":"Ortiz","year":"2008","journal-title":"J Neurol Ecuador"},{"key":"2025081307064780000_162.6.470.6","first-page":"48","article-title":"Haematological changes at altitude","volume":"157","author":"Wheatly","year":"2011","journal-title":"J R Army Med Corps"},{"key":"2025081307064780000_162.6.470.7","first-page":"197","article-title":"Thrombosis as a complication of extended stay at high altitude","volume":"14","author":"Anand","year":"2001","journal-title":"Nat Med J India"},{"key":"2025081307064780000_162.6.470.8","doi-asserted-by":"crossref","first-page":"313","DOI":"10.4103\/0971-3026.29004","article-title":"Rare case of cerebral stroke & venous thrombosis developed during high altitude expedition","volume":"16","author":"Prabhakar","year":"2006","journal-title":"Indian J Radiol Imaging"},{"key":"2025081307064780000_162.6.470.9","first-page":"535","article-title":"Stroke in young adults: a study from a university hospital in north India","volume":"10","author":"Mehndiratta","year":"2004","journal-title":"Med Sci Monit"},{"key":"2025081307064780000_162.6.470.10","unstructured":"Helseth E , Lutsep H , Buchan A , et al . Posterior Cerebral Artery Stroke Medscape review, 2012. http:\/\/emedicine.medscape.com\/article\/2128100-overview (accessed 15 Oct 2014)."},{"key":"2025081307064780000_162.6.470.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2009.12.008"},{"key":"2025081307064780000_162.6.470.12","doi-asserted-by":"publisher","DOI":"10.1136\/jramc-157-01-05"}],"container-title":["Journal of the Royal Army Medical Corps"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jramc-2014-000372","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,13]],"date-time":"2025-08-13T14:06:54Z","timestamp":1755094014000},"score":1,"resource":{"primary":{"URL":"https:\/\/militaryhealth.bmj.com\/lookup\/doi\/10.1136\/jramc-2014-000372"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,2,16]]},"references-count":12,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2016,11,28]]},"published-print":{"date-parts":[[2016,12]]}},"alternative-id":["10.1136\/jramc-2014-000372"],"URL":"https:\/\/doi.org\/10.1136\/jramc-2014-000372","relation":{},"ISSN":["0035-8665","2052-0468"],"issn-type":[{"value":"0035-8665","type":"print"},{"value":"2052-0468","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,2,16]]}}}