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Coherence between Brain Cortical Function and Neurocognitive Performance during Changed Gravity Conditions
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Neurological altitude decompression sickness among U-2 pilots: 2002-2009.

Sean L Jersey1, Gregory L Hundemer, Rory P Stuart

  • 1David Grant USAF Medical Center, 60 MDTS/SGQX, 101 Bodin Circle, Travis AFB, CA 94535, USA. sean.jersey@us.af.mil

Aviation, Space, and Environmental Medicine
|July 14, 2011
PubMed
Summary

Increased altitude decompression sickness (DCS) with central nervous system (CNS) effects in U-2 pilots from 2002-2009 was linked to more frequent and longer high-altitude flights. This highlights the need for revised flight protocols to prevent future pilot injuries.

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Area of Science:

  • Aerospace Medicine
  • Neurology
  • Physiology

Background:

  • U-2 pilots experienced a rise in altitude decompression sickness (DCS) with central nervous system (CNS) involvement between 2002-2009.
  • This increase in severity prompted a U.S. Air Force investigation to prevent further pilot incidents.

Purpose of the Study:

  • To retrospectively examine neurological DCS cases in U-2 pilots during 2002-2009.
  • To identify factors contributing to the increased incidence and severity of CNS DCS.

Main Methods:

  • Retrospective analysis of neurological DCS cases among U-2 pilots.
  • Utilized existing data sources due to the urgency of the situation.

Main Results:

  • 16 confirmed and 4 possible CNS DCS incidents occurred in U-2 pilots.
  • A majority of confirmed cases (12/16) and severe incidents were concentrated at one location, correlating with increased combat operations.
  • Delayed symptom recognition, symptom recurrence, and persistent neuropsychiatric symptoms were noted, suggesting potential long-term injury.

Conclusions:

  • Increased cockpit activity and prolonged high-altitude exposure likely contributed to the rise in U-2 CNS DCS.
  • Recommendations include adjusting preoxygenation, cabin altitude, in-flight exercise, and flight frequency to mitigate DCS incidence.