title: A case of cerebral aneurysm rupture and subarachnoid hemorrhage associated with air travel.
abstract: During air travel, passengers are exposed to unique conditions such as rapid ascent and descent that can trigger significant physiological changes. In addition, the cabins of commercial aircraft are only partially pressured to 552-632 mmHg or the equivalent terrestrial altitudes of 1,500-2,500 m (5,000-8,000 feet) above sea level. While studies in high-altitude medicine have shown that all individuals experience some degree of hypoxia, cerebral edema, and increased cerebral blood flow, the neurological effects that accompany these changes are otherwise poorly understood. In this study, we report a case of acute subarachnoid hemorrhage from a ruptured cerebral aneurysm associated with travel on commercial aircraft. We then review relevant cases of neurological incidents with possible air travel-related etiology and discuss the physiological factors that may have contributed to the patient's acute subarachnoid hemorrhage. In the future, this report may serve as reference for more detailed and conservative medical guidelines and recommendations regarding air travel.
authors.affiliation: Beijing United Family Hospital, Beijing, People's Republic of China; Department of Biological Sciences, Columbia University, New York, NY, USA.
authors.forename: Victoria
authors.initials: V
authors.lastname: Cui
authors.affiliation: Beijing United Family Hospital, Beijing, People's Republic of China.
authors.forename: Timur
authors.initials: T
authors.lastname: Kouliev
authors.affiliation: Beijing United Family Hospital, Beijing, People's Republic of China.
authors.forename: Jason
authors.initials: J
authors.lastname: Wood
keywords: cabin pressure; cerebral edema; emergency; high-altitude; neurological; triage