Characteristics of In-Flight Stroke in Korea

초록

Objective: To investigate the clinical characteristics of in-flight stroke cases in Korea. Background: Atmospheric pressure decrease, low humidity and restricted motion take place during flight, and these environment change can precipitate the development of stroke. However, description of in-flight stroke case series has been limited until now. Method: Since the opening of Incheon international airport in 2001, our hospital branch has been located at the airport and all the emergency stroke patients have been referred to our hospital. We performed retrospective review of the prospectively collected stroke registry from January 2001 to October 2016. Routine stroke work up including brain MRI and and etiologic investigation was performed in all the patients. Results: During the study period, 18 in-flight stroke cases were identified among total 8542 ischemic stroke patients (11 men, 60±13.7 years old). Fifteen patients had cerebral infarction, and two patients had transient ischemic attack. One patient was diagnosed as cerebral venous thrombosis. On etiological classification, 10 large artery atherothrombosis, 1 septic embolism, 1 cryptogenic stroke, and 3 cardioembolism were identified. Nine patients reported to experience symptom during or immediately before (within 10 minutes) landing. Ten patients had flight for six hours or more. Compared to the patients with long flight time(≥6hrs), those with short flight time (<6hous) had the higher incidence of stroke occurrence around landings (20 vs 88%). Five patients were found as unconscious state after landing. These patients all had long flight time over 6 hours, and showed very poor outcomes. Six patients with clear onset during landing could receive intravenous thrombolysis or mechanical thrombectomy.