Sunstroke

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Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

A sunstroke (medical insolation, heliosis) is caused by intense solar radiation on the head - the resulting heat build-up in the head irritates the meninges. As a result, symptoms such as headache, nausea and vomiting, possibly also fever and impaired consciousness, typically occur a few hours later. Often, sunstroke occurs in children, as well as bald men. Read more here: What to do against sunstroke? Are There Effective Home Remedies? When do you have to see a doctor?

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. T67

Sunstroke: quick reference

What to do in case of sunstroke? Bring affected person into the shade, raise upper body / head, give drink, cool head, calm down
Risks of sunstroke: Severe sunstroke can cause the brain to swell (cerebral edema), and in extreme cases, death.
When to the doctor If there are signs of severe sunstroke or cerebral edema (deterioration of the condition, impaired consciousness, seizures, etc.)

Caution!

Symptoms of sunstroke usually only appear after the person has long been out of the sun.
Especially don't leave children with sunstroke alone.
Painkillers such as diclofenac or ibuprofen should only take those affected after consulting a doctor.
Call the ambulance if the victim loses consciousness or has seizures.

Sunstroke: symptoms

If the head or neck gets too much sun, sunstroke can result. The trigger is the long-wave heat rays (infrared rays) in sunlight. They can heat up the head locally, which irritates the meninges and, in severe cases, affects the brain itself. How to recognize a sunstroke can be found in the article Sunstroke - Symptoms.

Sunstroke: what to do?

There are a number of things you can do yourself with sunstroke. It depends, among other things, on its severity, which helps with a sunstroke. The following first aid measures are correct and important:

Shade: Bring the person affected to a cool, shady place, preferably in a cool, darkened room.
Correct positioning: Position the person on their back with the head and upper body slightly elevated to relieve the head and neck. For example, place a pillow underneath. Bed rest is advisable.
Cold compresses: These should cool the head and neck, possibly also the trunk of the person concerned. You can also use ice cubes or “cool packs” or “ice packs”, but never put them directly on the skin, but always with a layer of fabric in between (risk of frostbite!).
Calm down: Children with sunstroke in particular should be calmed down and not left alone until the unpleasant symptoms subside.
Drink a lot: Make sure that the person concerned drinks enough fluids (but not ice cold!), Provided that there is no impairment of consciousness.
Emergency call: Call the ambulance service if the patient loses consciousness, does not improve quickly, or even worsens noticeably.

Painkillers such as ibuprofen or diclofenac should only be given as first aid for sunstroke after consulting a doctor. These drugs must not be used in the event of a very strong sunstroke or heat stroke - alert the emergency doctor immediately!

Sunstroke: Home Remedies & Homeopathy

In addition to the measures mentioned above, some home remedies can also help with mild sunstroke. For example, you can make compresses with cold quark or yogurt for the patient's head and neck. This not only cools, but can also soothe sun-reddened skin.

If exposure to the sun was associated with profuse sweating, the person concerned may have lost many minerals. Then you can stir a teaspoon of salt into a cup of cooled tea or a glass of water and let the person drink it. If necessary, an electrolyte solution from the pharmacy can also be useful to compensate for the loss of salt due to heavy sweating (or vomiting).

Some people trust the support of homeopathy for various ailments. For example, the homeopathic medicines Natrium carbonicum, Belladonna and Glonoinum are said to be helpful in treating sunstroke. The effect of homeopathy has not yet been scientifically proven.

Sunstroke: Risks

Typical signs of sunstroke are symptoms such as a red, hot head, headache, dizziness and fatigue. Nausea, vomiting and a slight fever are also possible.

With severe sunstroke, the irritation and inflammation of the meninges can cause the patient to experience pain in the head and neck area as soon as they bend their head forward. In addition, the neck muscles become tense, which makes bending more difficult (neck stiffness). Doctors call these symptoms "meningism".

In the case of sunstroke, on the other hand, the circulation is usually not impaired. That is why there is only very seldom a danger to life, for example when a so-called brain edema develops as a complication of severe sunstroke. This is understood to mean an accumulation of fluid in the brain tissue: The inflammatory processes during sunstroke make the blood vessel walls more permeable, so that more fluid escapes into the tissue - the brain swells and presses against the skull wall, which, however, cannot escape. The more pronounced the brain swelling, the higher the pressure inside the skull. This can damage the sensitive brain cells. In addition, the high pressure compresses the finest blood vessels, which affects the supply of nerve cells.

In addition to headaches, nausea, vomiting and dizziness, an increase in intracranial pressure can trigger the following symptoms, among others:

Fits (seizures)
Disturbances in consciousness (such as confusion, drowsiness and even coma)
decreased breathing to respiratory arrest (respiratory depression)

Signs of sunstroke in young children

Infants and young children are particularly prone to sunstroke because of the thinner hair on their heads and thinner skull bones. In small children who cannot speak yet, the typical signs of sunstroke are usually more difficult to see. Parents should therefore pay attention if their offspring behaves abnormally after spending time in the sun. In the case of infants, this includes, for example, high-pitched screaming or refusing to eat. In addition, the parents can use the back of their hands to feel whether the child's head is overheated.

Sunstroke: when to see a doctor?

Whether or not to seek medical advice depends on how severe the sunstroke is and how the patient's condition is developing. The symptoms usually subside within hours to a maximum of two days. Adults often recover faster than children.

However, if the condition of the person concerned does not improve or if it even worsens to the point of unconsciousness, you should immediately take the patient to a doctor or call the emergency doctor!

Sunstroke: medical examinations

If a sunstroke is suspected, the doctor will first take the medical history (anamnesis). This means: He asks the patient or the parents (in the case of affected children) various questions that are important for the diagnosis. Examples:

How long have you / your child been in the sun?
What complaints did you have?
When exactly did the symptoms arise?
Have you noticed any disturbances in consciousness such as confusion in your / your child?
Are there any known medical conditions?

Physical examinations

In the next step, the doctor measures the patient's body temperature, blood pressure and heart rate. In the case of a sunstroke, all three parameters are usually inconspicuous. The skin temperature on the head or forehead is also meaningful. It is often increased with sunstroke. The scalp can also be visibly reddened.

The doctor also checks whether the meninges are irritated. An indication of this is painfully tense neck muscles, which make it difficult or impossible for the patient to lower the chin towards the sternum (meningism). Another indication is the so-called Brudzinski sign. The doctor lifts the head of the patient lying on his back vigorously in the direction of the chest.If the meninges are irritated, the patient pulls their legs reflexively in order to reduce the tension on the membranes of the spinal cord.

In addition, the doctor will use simple questions to check the patient's orientation to time and place and test the reflexes of the brain stem (e.g. pupillary reflex).

Further examinations are usually not necessary in the case of a sunstroke. Additional examinations are only useful if the patient's circulation is unstable or if the doctor suspects increased intracranial pressure.

Investigations in suspected brain edema

If there is a suspicion of increased intracranial pressure due to cerebral edema, imaging procedures such as computed tomography (CT) or magnetic resonance imaging (MRI) can provide clarity.

If these examinations do not show any signs of increased intracranial pressure, the nerve fluid (liquor) is examined. In the case of a bacterial or viral cause of the symptoms, typical traces can be found in the liquor, but in the case of a sunstroke the finding is normal. A sample of the nerve water is obtained by means of a liquor puncture.

Exclusion of other causes

During his examinations, the doctor must take into account that symptoms such as those caused by sunstroke can also occur with other diseases. These include:

Heat collapse and heat stroke: These two clinical pictures are similar to severe sunstroke. The distinction is very important, however, as heat collapse and heat stroke require different treatment.
Neuro-borreliosis and TBE: Both infections are transmitted by ticks. Among other things, they can cause sunstroke-like symptoms such as reddening of the skin (Lyme disease), fever, weakness and malaise.
Meningitis (meningitis): A sunstroke is often accompanied by a slight inflammation of the meninges. Symptoms similar to those of bacterial or viral meningitis can then occur. Typically, however, bacterial meningitis, unlike sunstroke, is associated with a high fever.
Stroke: It occurs when the blood supply to parts of the brain is acutely interrupted (e.g. by a clot). Possible signs are, for example, severe headaches, drowsiness and dizziness - symptoms that can also occur with a sunstroke.

Sunstroke: Treatment by the doctor

Treatment for sunstroke is based on its severity. As a rule, sunstroke can be treated well by yourself (bed rest in a cool, darkened room, drinking a lot, etc.). In severe cases (such as impaired consciousness), treatment in the hospital is necessary, possibly even in the intensive care unit.

The doctor can, for example, give the patient infusions to stabilize the circulation. Certain drugs, among other things, help with increased intracranial pressure. Epileptic seizures, which can occur as part of a severe sunstroke, can also be treated with medication.

Prevent sunstroke

Naturally, sunstroke occurs much more frequently in summer when people spend a lot of time outdoors - be it sunbathing, exercising, hiking in the mountains or driving a convertible. People who have little or no protective hair on their heads are particularly at risk. These are mainly infants and toddlers, but also those with bald heads. Especially these risk groups should therefore not stay too long in the blazing sun. This is especially true during the sunniest part of the day, which means: avoid midday sun. In the English-speaking world there is a simple motto: "Between eleven and three, stay under a tree", in German: Between 11 a.m. and 3 p.m., stay under a tree (i.e. in the shade).

If a (longer) stay in the sun cannot be avoided, you should at least wear a hat. On the other hand, sunscreen (e.g. for babies or bald people) is ineffective as head protection. This is because it only partially blocks the ultraviolet rays, but not the heat rays (infrared rays) that cause sunstroke. Only headgear such as a scarf, hat or cap can help against this.

Headgear that does not allow any sun rays to penetrate the skull and thus prevent it from heating up is particularly recommended. These are mainly light-colored headgear: they reflect most of the sunlight. This means that the head cannot heat up as much underneath as, for example, under black textiles. This is an effective way of preventing sunstroke.

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