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Cerebral infarction in a 24-year-old pilot.
Koichiro Ohashi1, Kuniaki Nakanishi, Daijiro Miyajima
1Third Division, Aeromedical Laboratory, Japan Air Self-Defense Force, Tachikawa 190-8585, Tokyo, Japan. am1001@asdf.mail.jda.go.jp
Aviation, Space, and Environmental Medicine
|October 15, 2003
Summary
A young pilot experienced a stroke linked to heavy smoking, a rare occurrence in young adults. This case highlights diagnostic challenges and aeromedical considerations for pilots with cerebral infarction.
Area of Science:
- Neurology
- Aerospace Medicine
Background:
- Ischemic stroke is uncommon in young adults, presenting unique diagnostic and management challenges.
- This case involves a 24-year-old pilot experiencing cerebral infarction with an undetermined cause, potentially linked to chain smoking.
Observation:
- The patient presented with dysphasia, stupor, and right facial nerve palsy.
- Computed tomography (CT) revealed a low-density area in the left insular cortex.
- Cerebroangiography demonstrated severe stenosis in a left middle cerebral artery branch.
Findings:
- The patient recovered rapidly within 72 hours.
- Magnetic Resonance Imaging (MRI) 2 months post-event showed T2-weighted hyperintensity.
- MRI with Fluid Attenuated Inversion Recovery (FLAIR) sequence 10 months later confirmed cerebral infarction.
Implications:
- Cerebral infarction is an aeromedically disqualifying condition for pilots in the Japan Air Self-Defense Force.
- Differentiating between cerebral infarction and reversible ischemic neurological deficit (RIND) can be difficult in the early stages.
- The case underscores the importance of evaluating risk factors for stroke in young adults, particularly pilots.