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The first patient, a healthy 21-year-old man with no history of migraine, flew to Mexico City (elevation, 2241 m). He ascended by vehicle to 3950 m over a period of four days to begin an ascent of Popocatépetl (elevation, 5452 m). After a day of rest, he climbed to an altitude of 4400 m without problems. The next morning, the climber appeared startled and confused. Though alert, he was unable
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