Clinical Medicine Insights: Pathology (Jan 2008)

First-ever Ischemic Stroke after a Flight in a Patient with Prior Poliomyelitis

  • Cheng-Chiang Chang,
  • Shin-Tsu Chang,
  • Chih-Hung Ku,
  • Shang-Lin Chiang,
  • Hsiao-Ying Chang,
  • Min-Hsin Lai,
  • Kao-Chung Tsai,
  • Liang-Cheng Chen

DOI
https://doi.org/10.4137/CPath.S476
Journal volume & issue
Vol. 1

Abstract

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Survivors of poliomyelitis sometimes travel by air with mobility assistance. However, prolonged seating during long-haul flights may also possibly produce stroke events on polio-inflicted patients. A 48-year-old polio-inflicted male suffered a stroke after an extended flight. A two-dimensional echocardiography was normal without detected patent foramen ovale or dyskinetic segment. The venodynamic variables were all within normal limits. MR Imaging studies revealed acute cerebral infarction in the distribution of the right middle cerebral artery and posterior watershed area. Hematological examination revealed positive anti-cardiolipin IgG antibody which might contribute to the risk of thrombosis as an underlying condition in addition to immobilization. This is the first presentation of ischemic stroke after a flight in a patient with prior poliomyelitis. In addition to decompression sickness, economy class stroke syndrome and postpoliomyelitis syndrome, the physician should also take other coagulation disorders into consideration during the investigation.