A 62-Year-Old Woman With Cerebral Artery Air Embolism During Commercial Air Travel

Abstract

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.

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

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.

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.