Cerebral air embolism resulting in fatal stroke in an airplane passenger with a pulmonary bronchogenic cyst.

INTRODUCTION

Cerebral air embolism is a rare cause of stroke, but may occur in patients undergoing invasive cardiac and pulmonary procedures, as well as in divers suffering pulmonary barotrauma from rapid ascent. Cerebral air embolism during air travel, however, is particularly rare.

CASE

We present a case of a previously healthy gentleman who presented with an acute stroke after a commercial flight; the stroke was initially felt to be of cardioembolic origin. A large intrapulmonary cyst was noted on his imaging studies, but thought to be an incidental finding. During a return flight, he suffered another stroke and was found to have cerebral air emboli.

CONCLUSION

This case suggests the importance of considering cerebral air embolism in patients with stroke associated with air travel; restricting air travel in patients with intrapulmonary cysts may be prudent.