title: Cerebral infarction in a 24-year-old pilot.
abstract: Ischemic stroke is a rare event in young adults. We report on a 24-yr-old pilot with cerebral infarction of undetermined etiology, temporally associated with chain smoking. The patient exhibited dysphasia, stupor (confused consciousness), and right facial-nerve palsy. Computed-tomography revealed a low-density area in the left insular cortex. Cerebroangiography showed severe stenosis in a branch of the left middle cerebral artery. After admission, the patient made a rapid and uneventful recovery within 72 h. MRI showed an area of hyperintensity on T2-weighted images 2 mo after the attack. Based on the hyperintense area on FLAIR (fluid attenuated inversion recovery sequence) images obtained in MRI performed 10 mo after the attack, we diagnosed a cerebral infarction. In the Japan Air Self-Defense Force, cerebral infarction is an aeromedically disqualifying condition. However, in the evaluation 2 mo after the attack, differentiation from reversible ischemic neurological deficit was difficult. We discuss the criteria used for diagnosis and the risk factors for cerebral infarction in young adults, as well as the aeromedical disposition of young pilots.
authors.affiliation: Third Division, Aeromedical Laboratory, Japan Air Self-Defense Force, Tachikawa 190-8585, Tokyo, Japan. am1001@asdf.mail.jda.go.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ohashi
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Nakanishi
authors.forename: Daijiro
authors.initials: D
authors.lastname: Miyajima
authors.forename: Koji
authors.initials: K
authors.lastname: Fukushima
authors.forename: Toshiki
authors.initials: T
authors.lastname: Shirotani
authors.forename: Keiichi
authors.initials: K
authors.lastname: Kuwamura
authors.forename: Andrew
authors.initials: A
authors.lastname: Tong
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D001037:Aphasia / Q000209:etiology; D002539:Cerebral Arterial Diseases / Q000150:complications; D002544:Cerebral Infarction / Q000209:etiology*; D003221:Confusion / Q000209:etiology; D003251:Constriction, Pathologic; D004608:Eligibility Determination; D006801:Humans; D007564:Japan; D008279:Magnetic Resonance Imaging; D008297:Male; D008889:Military Personnel; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D020432:Trochlear Nerve Diseases / Q000209:etiology