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Aeromedical Implications of Cerebral Cavernomas
Aerospace Medicine and Human Performance
|January 20, 2021
Summary
Cerebral cavernous malformations (CCMs) are increasingly found in pilots. The UK Civil Aviation Authority (CAA) proposes a policy for certifying aircrew with CCMs, considering risks like epilepsy and hemorrhage.
Area of Science:
- Neurology
- Aerospace Medicine
- Radiology
Background:
- Cavernomas, also known as cerebral cavernous malformations (CCMs), are vascular anomalies in the brain.
- Increased use of imaging detects asymptomatic CCMs in aircrew.
- Aeromedical concerns include epilepsy, hemorrhage, and neurological deficits.
Purpose of the Study:
- To describe the UK Civil Aviation Authority's (CAA) experience with aircrew diagnosed with cavernomas.
- To evaluate aeromedical risks associated with cavernomas in pilots.
- To propose a medical certification policy for aircrew with CCMs.
Main Methods:
- Searched the CAA database (1990-2020) for 'cavernoma' cases in aircrew.
- Collected data on demographics, clinical presentation, and lesion characteristics.
- Conducted a PubMed literature review on CCM complications.
Main Results:
- Six CCM cases reported to the CAA (five professional, one private pilot).
- Two cases were symptomatic; four were asymptomatic.
- Literature review extracted complication rates (seizure, hemorrhage) and risk factors.
Conclusions:
- A policy for medical certification of aircrew with CCMs is proposed.
- The policy addresses both symptomatic and incidentally detected cases.
- Risk assessment and management are crucial for air safety.
