Economy class syndrome complicated by stroke

Scacciatella, Paolo; Butera, Gianfranco; Amato, Gianluca; Tomassini, Francesco; Giorgi, Mauro; Marra, Sebastiano

doi:10.2459/jcm.0b013e328336688e

Journal of Cardiovascular Medicine

2011

DOI: 10.2459/jcm.0b013e328336688e

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Economy class syndrome complicated by stroke

Paolo Scacciatella

Gianfranco Butera

Gianluca Amato

et al.

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Cited by 5 publications

(1 citation statement)

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“…1 On-board stroke has been reported in several scientific studies, although most were retrospective case series focusing on economy class stroke syndrome (ECSS). 2,3 This subtype of stroke results from paradoxical embolism through a patent foramen ovale or other right-to-left shunt, most likely in the context of deep vein thrombosis because of prolonged immobilization. In a recent registry, we observed 8 patients with ischemic stroke; only 2 had ECSS, whereas a high proportion of symptomatic high-grade carotid stenosis was ascertained.…”

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confidence: 99%

Stroke in Commercial Flights

Álvarez-Velasco

Masjuán

DeFelipe

et al. 2016

Stroke

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Background and Purpose— Stroke on board aircraft has been reported in retrospective case series, mainly focusing on economy class stroke syndrome. Data on the actual incidence, pathogenesis, and prognosis of stroke in commercial flights are lacking. Methods— A prospective registry was designed to include all consecutive patients referred from an international airport (40 million passengers a year) to our hospital with a diagnosis of ischemic stroke or transient ischemic attack and onset of symptoms during a flight or immediately after landing. Results— Forty-four patients (32 ischemic strokes and 12 transient ischemic attacks) were included over a 76-month period (January 2008 to April 2014). The estimated incidence of stroke was 1 stroke in 35 000 flights. Pathogeneses of stroke or transient ischemic attack were atherothrombotic in 16 (36%), economy class stroke syndrome in 8 (18%), cardioembolic in 7 (16%), arterial dissection in 4 (9%), lacunar stroke in 4 (9%), and undetermined in 5 (12%) patients. Carotid stenosis >70% was found in 12 (27%) of the patients. Overall prognosis was good, and thrombolysis was applied in 44% of the cases. The most common reason for not treating patients who had experienced stroke onset midflight was the delay in reaching the hospital. Only 1 patient with symptom onset during the flight prompted a flight diversion. Conclusions— We found a low incidence of stroke in the setting of air travel. Economy class stroke syndrome and arterial dissection were well represented in our sample. However, the main pathogenesis was atherothrombosis with a high proportion of patients with high carotid stenosis.

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confidence: 99%

Stroke in Commercial Flights

Álvarez-Velasco

Masjuán

DeFelipe

et al. 2016

Stroke

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When flying can cause stroke: a case of cerebral air embolism requiring craniectomy

Spagnolo,

Pinto,

Muscogiuri

et al. 2023

Acta Neurol Belg

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Airplane stroke syndrome

Humaidan

Yassi

Weir

et al. 2016

Journal of Clinical Neuroscience

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Economy class syndrome complicated by stroke

Cited by 5 publications

References 15 publications

Stroke in Commercial Flights

Stroke in Commercial Flights

When flying can cause stroke: a case of cerebral air embolism requiring craniectomy

Airplane stroke syndrome

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