飞行员颅内蛛网膜囊肿特点及医学鉴定

Characteristics and aeromedical evaluation of arachnoid cyst in pilots

目的总结飞行员颅内蛛网膜囊肿的临床特点及航空医学鉴定原则。方法对2008年1月—2012年12月我院确诊颅内蛛网膜囊肿的11例飞行员资料进行总结分析。结果 11例中,5例以头晕发病,2例以晕厥、意识丧失发病,1例以四肢无力发病,1例以失眠、性格改变发病,其余2例无症状体检时发现。辅助检查9例脑电图检查正常,2例为边缘状态脑电图。4例进行了低压舱试验,其中1例出现异常。2例心理测评无异常。1例观察期超龄停飞,1例首次入院后即予飞行合格结论,4例分别观察随访1～2年后,给予飞行合格结论,限双座飞行;另5例因存在不同程度的临床症状,给予暂时飞行不合格结论,继续观察随访。结论飞行员患颅内蛛网膜囊肿存在飞行中丧失行为能力的风险,一旦发现应立即暂停飞行,并系统检查神经精神状况,根据结果作出相应飞行结论。

Objective To summarize the clinical features and the aeromedical evaluation of intracranial arachnoid cysts in pilots. Methods A retrospective analysis of the clinical data of 11 pilots with intracranial arachnoid cysts was carried out from 2008 to 2012. Results Eleven patients were all male pilots, including 5 cases with onset of dizziness, two cases with syncope and loss of consciousness disease,one case with weakness, one case with insomnia and personality changes, and the remaining two cases with asymptomatic. There were normal EEG in 9 patients and EEG pattern of edge condition in 2. Four patients had low pressure chamber tests, including one was abnormal. One case was admitted to fly for the fist time in hospital, 4 cases were admitted to fly restricted to two-seater flight after 1～2 years of follow-up and 5 cases with clinical symptoms in observations continuously. Conclusion Intracranial arachnoid cysts can bring flight risk, so pliots with incranial arachnoid cysts should be stopped flying immediately and evaluated in systematic neuropsychiatric examination.