In-flight seizures and fatal air embolism: the importance of a chest radiograph.

OBJECTIVE To describe for the first time, to our knowledge, a case of recurrent in-flight-dependent seizures related to commercial airline flight in which the patient experienced a fatal air embolism secondary to a giant bronchogenic cyst. DESIGN Case report. SETTING University hospital. PATIENT A female airline passenger presented with a seizure, then unconsciousness and death. The patient had experienced 2 previous episodes of in-flight seizures without any sequelae. RESULTS The patient had an air embolism proved by findings on cranial computed tomography (CT) and a CT perfusion study. The embolism was secondary to a giant bronchogenic cyst that was evident on chest CT. The patient was examined after the previous episodes of in-flight seizures, but no chest radiography had been performed. CONCLUSIONS We propose minor air embolism as a cause of in-flight seizures. This type of seizure can signify the existence of a giant bronchogenic cyst. We believe that obtaining a chest radiograph can be useful in patients with a history of in-flight seizures to rule out the presence of a bronchogenic cyst and to prevent a possibly fatal air embolism.