Is there a neurologist on this flight?

Sirven, Joseph I; Claypool, David W.; Sahs, K. L.; Wingerchuk, D. M.; Bortz, Jennifer J.; Drazkowski, Joseph F.; Caselli, Richard J.; Zanick, D.

doi:10.1212/wnl.58.12.1739

Cited by 41 publications

(38 citation statements)

References 10 publications

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“…In a review of medical problems during commercial air flight, there was a low occurrence of non-alcohol-related mental status changes and TGA was not described. 4 Transient global amnesia has been defined as abrupt onset of temporary anterograde amnesia with a variable degree of patchy retrograde amnesia. 1,[5][6][7] Repetitive questioning occurs, but confabulation is uncommon.…”

Section: Discussionmentioning

confidence: 99%

Transient global amnesia following a transoceanic flight

Rashid¹,

Starer

2006

Psychiatry Clin Neurosci

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Transient global amnesia (TGA) is the abrupt onset of temporary anterograde amnesia without any focal neurological features. It is a benign condition and is completely reversible in most cases. However, the sudden occurrence of memory impairment can be especially alarming to an individual who has recently arrived in an unfamiliar setting. The cause of TGA remains unknown. Reported here is the unusual occurrence of TGA in a man following the completion of an international airplane flight. Possible etiologies of the episode are considered.

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Section: Discussionmentioning

confidence: 99%

Transient global amnesia following a transoceanic flight

Rashid¹,

Starer

2006

Psychiatry Clin Neurosci

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“…In-flight strokes (IFS) are a topic of concern [1]. Air passengers travel in partially pressurized cabins with an atmospheric pressure equivalent to 8,000 feet, which exposes them to lower partial pressures of ambient oxygen [2].…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the low humidity in cabin air [5] could favor cerebral venous occlusions [6], and the restricted mobility could result in leg thrombosis [7] and paradoxical embolization in patients with a right-left shunt [8]. Although airlines lack a common database to report in-flight medical emergencies [9], two systematic reviews of radio calls to an in-flight medical radio service (IFMRS) [1] and activations of emergency services at a major airport [10] underscore the high prevalence of in-flight neurological symptoms. While no accurate etiological diagnoses can be expected from such sources, it is reasonable to speculate that cerebrovascular disorders may have caused many of these acute neurological in-flight symptoms [1].…”

Section: Introductionmentioning

confidence: 99%

“…Although airlines lack a common database to report in-flight medical emergencies [9], two systematic reviews of radio calls to an in-flight medical radio service (IFMRS) [1] and activations of emergency services at a major airport [10] underscore the high prevalence of in-flight neurological symptoms. While no accurate etiological diagnoses can be expected from such sources, it is reasonable to speculate that cerebrovascular disorders may have caused many of these acute neurological in-flight symptoms [1]. In addition, IFS is likely to become more common paralleling predictions of growth for air travel [11], aging of the population, and more liberal regulations regarding the access of sick passengers to air transportation [12].…”

Section: Introductionmentioning

confidence: 99%

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Improving Pilot Response to In-Flight Strokes: A Randomized Controlled Trial

Leira¹,

Cruz‐Flores²,

Wyrwich³

et al. 2005

Cerebrovasc Dis

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Background: When a passenger suffers an in-flight stroke (IFS), the pilot decides when to expedite access to ground care. Pilot pro-activeness towards IFS could improve outcome and should be promoted. Unfortunately, little is known about a pilot’s stroke pro-activeness or limiting factors. Methods: Randomized controlled trial of an educational intervention (American Stroke Association, 30-slide stroke awareness lecture) through an internet-based computer system using pilot students and instructors as subjects. Pilots completed pre-intervention and post-intervention tests of 25 simulated in-flight scenarios that describe strokes and other neurological and medical symptoms. Outcomes chosen were the percentage of pilots that would use a medical radio service, declare an emergency on board, or divert to the nearest airport for each scenario. Results: Participant pilots (n = 104) were less likely to respond to IFS than to myocardial infarction (p < 0.001). Fear of retaliation by an employer was the most important modifiable limitation. The educational program increased the simulated rate of emergency declarations for in-flight vertebrobasilar strokes (p < 0.001) and subarachnoid hemorrhage (p < 0.001). Conclusions: Pilot-simulated response to certain IFS improves immediately after this educational intervention, which should be disseminated in schools and airlines. Further studies are needed to determine the long-term benefits of this intervention and the impact on actual diversion rates. Companies should also review their policies to shield pilots from retaliation when altering the flight plan for patients.

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“…A retrospective study with internationally acquired series of SAH may help a better understanding of flight complications both in its different steps (take off, cruise, landing) and in the short term post-flight consequences at ground level [13,14], which may be not enough considered in their relationships with air-travel.…”

mentioning

confidence: 99%

Flight-Related Aneurysmal Subarachnoid Hemorrhage and Its Complications During and after Landing

Fioravanti¹

2015

JNSK

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It has been suggested that the risk of rupture of intracranial aneurysms may be fostered by climatic drops in barometric pressure, as also occurs to passengers subjected to the air pressure settings inside aircraft cabins. We present two cases of flight-related aneurysmal SAH followed by intracerebral rebleeding in the cabin (case 1) and carotid dissection after landing (case 2). Management and complications of in-flight subarachnoid hemorrhage, influence of decreased cabin pressure on the aneurysm rupture, timing of hemorrhage related to flight exposure and counseling of patients with unruptured aneurysms are discussed.

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Is there a neurologist on this flight?

Cited by 41 publications

References 10 publications

Transient global amnesia following a transoceanic flight

Transient global amnesia following a transoceanic flight

Improving Pilot Response to In-Flight Strokes: A Randomized Controlled Trial

Flight-Related Aneurysmal Subarachnoid Hemorrhage and Its Complications During and after Landing

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