Neurology at the airport

Alonso‐Cánovas, Araceli; Felipe-Mimbrera, Alicia de; Gonzalez‐Valcarcel, Jaime; García‐Barragán, Nuria; Corral, Íñigo; Masjuán, Jaime

doi:10.1136/jnnp.2011.243709

Cited by 12 publications

(5 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Alonso-Cánovas et al, examined a cohort of patients with a recent history of airplane travel referred to a local hospital for neurological symptoms (5). Of 77 patients referred, 8 were diagnosed with an ischemic stroke and the majority of these patients (5/8) harbored high-grade carotid stenosis.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The safety of aeroplane travel in patients with symptomatic carotid occlusion

Reynolds

Kamath

Grubb

et al. 2013

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

Objective Patients with carotid stenosis or occlusion may be at increased risk for stroke during air travel. Records from the Carotid Occlusion Surgery Study (COSS), a randomized trial of surgical revascularization for complete carotid artery occlusion and hemodynamic ischemia, were examined for evidence of stroke related to air travel. Methods COSS subjects who travelled by airplane to a regional Positron Emission Tomography (PET) center for a screening cerebrovascular hemodynamic evaluation were identified. Maximum altitude and total flight time were estimated based on the distance between origin and destination. Ischemic events were determined by a structured telephone interview within 24 hours of travel. Patient demographics, co-morbidities, OEF data and 24-hour interview responses were recorded. Results Seventy-seven patients with symptomatic carotid occlusion travelled by airplane to a single PET center (174 flights). Fifty two (67.5%) were male and 25 (32.5%) were females. The average age was 58.7 ± 1.4 years. Twenty-seven patients (35.1%) demonstrated evidence of ipsilateral hemodynamic cerebral ischemia as measured by PET OEF, while 50 (64.9%) had normal OEF. Patients flew an average distance of 418.9 ± 25.9 miles for 107.1 ± 4.7 minutes per trip. No patient reported symptoms of a transient ischemic attack or stroke during or within 24 hours after airplane travel (95% CI 0 – 2.0%). Conclusions The risk of stroke as a consequence of air travel is low, even in a cohort of patients at high risk for future stroke owing to hemodynamic impairment. These patients with should not be discouraged from air travel.

show abstract

Section: Discussionmentioning

confidence: 99%

“…(4–7) Owing to this rationale, some authors have advocated counseling patients with atherosclerotic cerebrovascular disease to avoid commercial airplane travel. (5)…”

Section: Introductionmentioning

confidence: 99%

The safety of aeroplane travel in patients with symptomatic carotid occlusion

Reynolds

Kamath

Grubb

et al. 2013

Journal of Neurology, Neurosurgery & Psychiatry

View full text Add to dashboard Cite

show abstract

“…Eight patients had been included in a previous series of neurological problems on board. 4 The estimated incidence of stroke was 1 stroke in 35 000 flights.…”

Section: Resultsmentioning

confidence: 99%

“…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. 4 We designed a comprehensive prospective study that aimed to clarify etiologic, clinical, and prognostic features of ischemic stroke associated with commercial flights.…”

mentioning

confidence: 99%

Stroke in Commercial Flights

Álvarez-Velasco

Masjuán

DeFelipe

et al. 2016

Stroke

View full text Add to dashboard Cite

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.

show abstract

“…14 Additionally, the use of in-flight supplemental oxygen is also recommended for these travellers. In contrast to the dearth of literature on air travel in stroke patients, there is abundant literature that describes in-flight and post-flight stroke incidence [15][16][17] as well as repatriation due to CVA abroad. 18,19 Congenital Heart Disease The literature on congenital heart disease (CGHD) and air travel is limited.…”

Section: Coronary Heart Diseasementioning

confidence: 99%

Pre-travel Health Advice for Patients With Cardiovascular Disease

Liew

Flaherty

2019

Int J Travel Med Glob Health

View full text Add to dashboard Cite

Cardiovascular disease (CVD) is the leading cause of death among international travellers. Practitioner knowledge of the effects of CVD on international travel is imperative in order to promote a healthy travel experience. This review aimed to explore the available literature on this topic. The PubMed database was accessed to source relevant literature using combinations of relevant keywords as search terms. Articles were restricted to those published in the English language through March 2019. Of 1726 article records retrieved, 73 relevant papers were examined carefully. The results of this narrative review are related to multiple aspects of CVD and travel. The pre-travel consultation should address issues regarding vaccinations, travel insurance, anticoagulation, and medical devices. Additional vaccines to be discussed include influenza, pneumococcal, and hepatitis B. Patients with CVD should be advised of the need to carry a copy of their ECG, prescription(s), and pacemaker manufacturer’s card. Knowledge of the location overseas of automated external defibrillators and awareness of health risks associated with strenuous adventure activities are important for CVD travellers. Medical tourism for patients with CVD is briefly considered. Space tourism is an emerging category of extreme international travel that requires specialized pre-travel preparation. This narrative review article highlights the gaps in the travel medicine literature in relation to CVD. A strong evidence base for most recommendations is lacking. Future scholarly efforts are warranted to facilitate more robust travel recommendations for CVD patients. No qualitative studies to date have described the experiences of international travellers with CVD.

show abstract

Neurology at the airport

Cited by 12 publications

References 14 publications

The safety of aeroplane travel in patients with symptomatic carotid occlusion

The safety of aeroplane travel in patients with symptomatic carotid occlusion

Stroke in Commercial Flights

Pre-travel Health Advice for Patients With Cardiovascular Disease

Contact Info

Product

Resources

About