Spectra of intracranial diseases in Chinese military pilots(cadets)unqualified for transfer to pilot modified high performance aircraft

BACKGROUND With very high mortality and disability rates,cerebrovascular diseases and intracranial tumors severely threaten the health and fighting strength of flying personnel,requiring great concern and intensive screening in clinic,early warning in an early and accurate manner and early intervention of diseases possibly resulting in inflight incapacitation are key emphases of aeromedical support in clinic.AIM To probe into the spectra of intracranial diseases,flight factors and medical imaging characteristics of military pilots(cadets)in the physical examination for transfer to pilot modified high performance aircraft,thus rendering theoretical references for clinical aeromedical support of pilots.METHODS A total of 554 military pilots(cadets)undergoing physical examination for transfer to pilot modified high performance aircraft from December 2020 to April 2024 in a military medical center were enrolled in this study.Then,a retrospective study was carried out on intracranial disease spectra and head magnetic resonance imaging(MRI)data of 36 pilots(cadets)who were unqualified for transfer to pilot modified high performance aircraft.Besides,a descriptive statistical analysis was conducted on the clinical data,age,fighter type and head MRI data of such pilots(cadets).RESULTS Abnormal head images were found in 36 out of 554 pilots(cadets)participating in the physical examination for transfer to pilot modified high performance aircraft,including arachnoid cyst in 17(3.1%)military pilots(cadets),suspected very small aneurysm in 11(2.0%),cavernous hemangioma in 4(0.7%),vascular malformation in 2(0.4%),and pituitary tumor in 3(0.5%,one of which developed cavernous hemangioma simultaneously).Among the 17 pilots(cadets)with arachnoid cyst,4 were identified as unqualified for transfer to pilot modified high performance aircraft because the marginal brain tissues were compressed by the cyst>6 cm in length and diameter.The 11 pilots(cadets)with suspected very small aneurysms identified by 3.0T MRI consisted of 6 diagnosed with conus arteriosus by digital subtraction angiography and qualified for transfer to pilot modified high performance aircraft,and 5 identified as very small intracranial aneurysms with diameter<3 mm and unqualified for transfer to pilot modified high performance aircraft.No symptoms and signs were observed in the 4 military pilots(cadets)with cavernous hemangioma,and the results of MRI revealed bleeding.The 1 of the 4 had the lesion located in pons and developed Rathke cyst in pituitary gland at the same time,and unqualified for transfer to pilot modified high performance aircraft.The 2 of the 4 were unqualified for flying,and 2 transferred to air combat service division.The 2 pilots(cadets)with vascular malformation were identified as unqualified for transfer to pilot modified high performance aircraft.Among the 3 pilots(cadets)with pituitary tumor,one pilot cadet was identified as unqualified for flying since the tumor compressed the optic chiasma,one had cavernous hemangioma in pons in the meantime and transferred to air combat service division,and one was diagnosed with nonfunctional microadenoma and qualified for transfer to pilot modified high performance aircraft.CONCLUSION High-resolution head MRI examination is of great significance for screening and detecting cerebrovascular diseases and intracranial tumors in military flying personnel,and attention should be paid to its clinical application to physical examination for transfer to pilot modified high performance aircraft.

Clinical Analysis of Children with Corpus Callosum Pressure Lesion Syndrome

Objective The aim of the study was to investigate the clinical features,imaging features,and prognosis of splenium of the corpus callosum in children in order to improve the clinical understanding.Methods The clinical data and imaging data of 30 children with splenium of the corpus callosum treated in Xiamen Children’s Hospital from June 2017 to October 2019 were retrospectively analyzed.Results Thirty children aged from 19 months to 12 years,with an average age of 5.4 years were included in the study;all had fever and other prodromal infections at acute onset,including 15 cases of respiratory tract infection,9 cases of digestive tract infection,and 6 cases of central nervous system infection.According to cranial magnetic resonance imaging(MRI)findings,23 cases had type I syndrome and 7 cases had type II syndrome;23 children had clinical symptoms disappeared after 1 week,7 children had clinical symptoms disappeared after 1 month,and 23 children had the abnormal signal disappeared after 2 weeks of reexamination,and the abnormal signal disappeared completely after 1 month of reexamination in 7 children.Conclusion Central nervous system infection is also a predisposing factor for the pressor syndrome of the corpus callosum in children in addition to upper respiratory tract infection and gastrointestinal tract infection,and all children have good prognosis.