Abstract

Background: Cerebral air embolism (CAE) may exceptionally occur in patients with thoracic lesions during air travelling. Methods: We present 5 new cases of CAE during flights and review precedent cases. Results: Five patients with CAE were admitted to our Emergency Department (A-E). All experienced loss of consciousness (LOC). Chest radiograph showed thoracic bullae. Brain computed tomography (CT) showed subarachnoid bubbles (A), intraparenchymal bubbles (B), global hypoperfusion (C), or no abnormalities (D, E). With supportive treatment, four survived, while B died. Including ours, 18 cases of CAE during commercial flights have been reported. LOC and dyspnea were common. Thoracic cysts (9) and bullae (9) were found. Ten died. Five had experienced episodes suggesting CAE during previous flights. In patients with complete recovery, infarction, edema and intraparenchymal bubbles were absent in basal neuroimaging. Conclusions: CAE may occur in patients with thoracic cysts while air travelling, causing typically neurological and respiratory symptoms early in the flight.

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