A 62-year-old woman with cerebral artery air embolism during commercial air travel.
OBJECTIVE
Air embolism to the cerebral artery circulation is a rare complication previously associated with surgery, scuba-diving, induced abortion, angiography, and pneumothorax. However, air embolism secondary to a ruptured air bulla during commercial air travel has rarely been reported.


METHODS
We report a patient who became unconsciousness 30 minutes after her plane took off.


RESULTS
The patient was found to have an acute brain infarct in a watershed distribution secondary to multiple, bilateral, intraparenchymal air bubbles. Further investigation revealed a large lung bulla with an air-fluid level.


CONCLUSIONS
Air embolism was due to rupture of the lung bulla into the pulmonary venous outflow. Whether the rupture was spontaneous or due to a stretch injury from a change of air pressure resulting in pulmonary barotrauma occurring during commercial air travel is uncertain.
Salameh
Johnny
J
Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA. johnnysalameh@hotmail.com
D000208:Acute Disease; D000401:Aircraft; D020520:Brain Infarction / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D002539:Cerebral Arterial Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D004618:Embolism, Air / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed