PET scan as an aid for the return of a head-injured aviator to flying duty

Head injury is not a rare event in aviators, and poses a difficult dilemma for the flight surgeon regarding return to flying duty due to the fear of post-traumatic epilepsy. Positron emission tomography (PET) is a functional neuroimaging modality that provides additional localizing data in epileptic patients in the interictal phase. We describe a case of penetrating head trauma with no loss of consciousness in a military jet fighter pilot in which the magnetic resonance imaging revealed a minimal brain contusion. PET scan was used as an additional tool for predicting the epileptogenic potential of this finding, thus aiding the decision regarding the return of the aviator to flying duty.