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Related Experiment Videos

Chiari-I malformation in two fighter pilots.

Ahmet Akin1, Zafer Canakci, Ahmet Sen

  • 1Gülhane Military Medical Academy, Department of Aerospace Medicine, Eskisehir, Turkey.

Aviation, Space, and Environmental Medicine
|July 17, 2003
PubMed
Summary

Two fighter pilots with Chiari Malformation Type I experienced flight-related symptoms like headaches and disequilibrium. This congenital condition, typically symptomatic earlier in life, presented asymptomatically in these pilots until high-G maneuvers exacerbated their symptoms.

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Area of Science:

  • Neurology
  • Aerospace Medicine
  • Neurosurgery

Background:

  • Chiari Malformation Type I involves cerebellar tonsil herniation through the foramen magnum.
  • It typically causes neurological symptoms due to brainstem, spinal cord, and cerebellum dysfunction.
  • While often symptomatic in youth, cases can present later or be asymptomatic.

Observation:

  • Two fighter pilots in the Turkish Air Force with asymptomatic Chiari-I successfully completed demanding physiological training, including centrifuge exposure.
  • These pilots developed symptoms including headache, neck spasms, and disequilibrium specifically during high +Gz flight training sorties.

Findings:

  • Chiari Malformation Type I can manifest symptoms in pilots under specific physiological stress (+Gz) even if asymptomatic during routine activities.

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  • The Valsalva maneuver or straining, which increases intracranial pressure, may provoke symptoms in individuals with Chiari-I.

    • Implications:

    • This case series suggests a need for careful aeromedical evaluation of pilots with Chiari-I, considering flight-specific stressors.
    • Understanding the potential for acquired symptoms and the aeromedical disposition is crucial for managing aviators with Chiari malformations.