Press Release

The researchers, led by Dr. Patrick Pullicino, chairman of the Department of Neurosciences at UMDNJ-New Jersey Medical School, reported the connection, called "economy class stroke syndrome," in three healthy, young travelers who suffered ischemic strokes during or shortly after long air trips.

"What's remarkable is that all three patients were under 50 years of age and all were healthy, non-obese, non-smokers with no vascular risk factors and therefore not expected to be at risk for stroke," Dr. Pullicino said. "Several previous studies have pointed out that travelers aboard prolonged airplane flights are at risk for developing blood clots in their legs (deep vein thrombosis) that may travel to their lungs (pulmonary embolism) and may be fatal.

Prolonged sitting associated with air travel in known to be a cause of clots forming in the legs. Upwards of 30 percent of the normal population is estimated to have patent furaman ovale (PFO), a common condition where a small hole exists between the right and left sides of the heart. PFO rarely causes any adverse medical condition and can only be determined through specific diagnostic tests such as an echocardiogram.

The research, published in the March 26 edition of Neurology, recounts the cases of three air travelers who sustained a stroke during or after a flight. The first traveler suffered sudden loss of vision four hours into a 12-hour flight and the second developed paralysis down one side of the body at the conclusion of a 14-hour flight. The third person lost hearing in one ear 12 hours after completing two 90-minute flights, separated by a six-hour wait in an airport transit lounge.

The three individuals were all found to have ischemic strokes, the most common type of stroke. It occurs when a clot that is formed in a blood vessel, breaks loose and travels to the brain where it blocks the flow of blood.

"Because PFO is so common, more people may be at risk for strokes during or after prolonged air travel," Dr. Pullicino said. "This is particularly true for people who have a history of deep vein thrombosis, pulmonary embolism or prior strokes. I would strongly urge people with these conditions to ask their physicians if they also have PFO."

Although "economy class stroke" may be difficult to predict, Dr. Pullicino offered these suggestions to help travelers avoid falling victim to this syndrome during flights that last longer than four hours:

• Drink plenty of liquids to avoid becoming dehydrated. When the body dehydrates, the blood starts to thicken and becomes more likely to clot.
  
• Avoid alcohol because it causes the body to dehydrate.
  
• Get up and move around frequently to keep blood from pooling in the legs. If unable to get up to move around, exercise the lower legs by extending them and flexing the ankles and toes. Exercise the thighs by sliding the feet back and forth on the floor.
• Wear compression stockings to help prevent the formation of blood clots in the legs.
  

Dr. Pullicino also suggested that travelers check with their physicians to see if they require any additional preventive measures before embarking on a long air trip.

The UMDNJ-New Jersey Medical School is one of three medical schools of the University of Medicine and Dentistry of New Jersey. UMDNJ comprises New Jersey's only medical schools, the state's only dental school, a nursing school, a graduate school of biomedical sciences, a school of health related professions and a school of public health on campuses in Newark, Piscataway/New Brunswick, Camden, Stratford, and Scotch Plains. UMDNJ also operates University Hospital, Newark, and University Behavioral HealthCare. It is affiliated with more than 200 health care and educational institutions throughout the state.