FLIGHT ASSOCIATED DISSECTION

Area of Science:

• Neurology
• Vascular Medicine
• Aerospace Medicine

Background:

• "Economy Class Stroke" is a recognized term for paradoxical embolisms linked to patent foramen ovale (PFO) in individuals undertaking long-distance flights.
• However, the potential for other central nervous system (CNS) pathologies associated with prolonged air travel remains less explored.
• Vascular dissection, a serious condition involving tears in blood vessel walls, requires careful consideration in diverse clinical scenarios.

Purpose of the Study:

• To investigate potential central nervous system (CNS) complications of long-distance flights beyond the scope of "Economy Class Stroke" related to patent foramen ovale.
• To present and analyze cases of vascular dissection occurring after long-haul flights.
• To raise awareness among clinicians regarding the risk of vascular dissection in the context of air travel.

Main Methods:

• Case report analysis of two patients presenting with neurological symptoms after long-distance flights.
• Review of medical history, diagnostic imaging (e.g., CT angiography, MRI), and clinical outcomes for both cases.
• Literature review on CNS events associated with air travel and vascular dissection.

Main Results:

• Two distinct cases of arterial vascular dissection (e.g., carotid or vertebral artery dissection) were identified in patients following long-distance flights.
• The clinical presentations varied, but symptoms were attributed to the vascular dissection events.
• These findings suggest a potential association between prolonged immobility and physiological changes during flights and the occurrence of vascular dissection.

Conclusions:

• Long-distance flights may be associated with an increased risk of central nervous system (CNS) events, including vascular dissection, not solely limited to patent foramen ovale-related strokes.
• Vascular dissection should be considered in the differential diagnosis for patients presenting with neurological symptoms after prolonged air travel.
• Further research is warranted to elucidate the mechanisms and precise risks of vascular dissection related to air travel.