{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:31:18Z","timestamp":1790742678018,"version":"4.1.0"},"reference-count":27,"publisher":"Aerospace Medical Association","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Incidental neuroanatomical findings are commonly identified during brain MRI completed clinically, for research, or for other purposes, including aircrew screening. Such findings range from benign to pathological and some may be disqualifying for flight duties. We present a series of cases with incidental neuroanatomical findings identified in Royal Canadian Armed Forces (RCAF) aircrew during the Canadian White Matter Hyperintensity research study, and the subsequent aeromedical evaluation undertaken to manage them. Our study group performed 48 brain MRI scans on 42 RCAF pilots and 6 aviation physiology technicians and parajumpers. Participants were men ages 25\u201370 with a mean age of 39.<\/jats:p>\n<jats:p><jats:bold>CASE SERIES:<\/jats:bold> Incidental neuroanatomical findings were detected in four pilots, with six distinct findings (four vascular abnormalities, one arachnoid cyst, and one nonspecific nodule). All cases were asymptomatic. After evaluation of the findings of each case by a medical consortium, including an aeromedical neurologist, all pilots were cleared for ongoing duties with no restrictions.<\/jats:p>\n<jats:p><jats:bold>DISCUSSION:<\/jats:bold> The rate and nature of incidental findings in RCAF members in the White Matter Hyperintensity Study is consistent with that found in both the general population and in other military pilot populations. There is no international standard for screening or management of incidental findings; therefore, we recommend an approach that involves a case-by-case evaluation of the findings by a multidisciplinary medical team, with careful identification and consideration for high-risk features.<\/jats:p>\n<jats:p><jats:bold>Danho S, Saary J. <jats:italic>Incidental findings on MRI brain imaging in pilots from the Canadian White Matter Hyperintensity Study<\/jats:italic>. Aerosp Med Hum Perform. 2025; 96(3):255\u2013259.<\/jats:bold><\/jats:p>","DOI":"10.3357\/amhp.6388.2025","type":"journal-article","created":{"date-parts":[[2025,2,20]],"date-time":"2025-02-20T00:01:16Z","timestamp":1740009676000},"page":"255-259","source":"Crossref","is-referenced-by-count":1,"title":["Incidental Findings on MRI Brain Imaging in Pilots from the Canadian White Matter Hyperintensity Study"],"prefix":"10.3357","volume":"96","author":[{"given":"Sharef","family":"Danho","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Saary","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1911","reference":[{"issue":"2","key":"B1","series-title":"J Neurosurg.","first-page":"222","article-title":"Prevalence and natural history of arachnoid cysts in adults","volume":"118","author":"Al-Holou WN","year":"2013","unstructured":"Al-Holou WN, Terman S, Kilburg C, Garton HJ, Muraszko KM, Maher CO. Prevalence and natural history of arachnoid cysts in adults. J Neurosurg. 2013; 118(2):222\u2013231. 10.3171\/2012.10.JNS12548"},{"issue":"990","key":"B2","series-title":"Br J Radiol.","first-page":"456","article-title":"Incidental findings found in \u201chealthy\u201d volunteers during imaging performed for research: current legal and ethical implications","volume":"83","author":"Booth TC","year":"2010","unstructured":"Booth TC, Jackson A, Wardlaw JM, Taylor SA, Waldman AD. Incidental findings found in \u201chealthy\u201d volunteers during imaging performed for research: current legal and ethical implications. Br J Radiol. 2010; 83(990):456\u2013465. 10.1259\/bjr\/15877332"},{"issue":"2","key":"B3","series-title":"Radiology.","first-page":"507","article-title":"Prevalence, clinical management, and natural course of incidental findings on brain MR images: the population-based Rotterdam Scan Study","volume":"281","author":"Bos D","year":"2016","unstructured":"Bos D, Poels MM, Adams HH, Akoudad S, Cremers LG,  Prevalence, clinical management, and natural course of incidental findings on brain MR images: the population-based Rotterdam Scan Study. Radiology. 2016; 281(2):507\u2013515. 10.1148\/radiol.2016160218"},{"issue":"1","key":"B4","series-title":"Neurology.","first-page":"e89","article-title":"Hemorrhage from cerebral cavernous malformations: the role of associated developmental venous anomalies","volume":"95","author":"Chen B","year":"2020","unstructured":"Chen B, Herten A, Saban D, Rauscher S, Radbruch A,  Hemorrhage from cerebral cavernous malformations: the role of associated developmental venous anomalies. Neurology. 2020; 95(1):e89\u2013e96. 10.1212\/WNL.0000000000009730"},{"issue":"2","key":"B5","series-title":"J Neurosurg.","first-page":"437","article-title":"Natural history of cerebral arteriovenous malformations: a meta-analysis","volume":"118","author":"Gross BA","year":"2013","unstructured":"Gross BA, Du R. Natural history of cerebral arteriovenous malformations: a meta-analysis. J Neurosurg. 2013; 118(2):437\u2013443. 10.3171\/2012.10.JNS121280"},{"issue":"6","key":"B6","series-title":"Stroke.","first-page":"1980","article-title":"The presentation and clinical course of intracranial developmental venous anomalies in adults: a systematic review and prospective, population-based study","volume":"40","author":"Hon JM","year":"2009","unstructured":"Hon JM, Bhattacharya JJ, Counsell CE, Papanastassiou V, Ritchie V,  The presentation and clinical course of intracranial developmental venous anomalies in adults: a systematic review and prospective, population-based study. Stroke. 2009; 40(6):1980\u20131985. 10.1161\/STROKEAHA.108.533034"},{"issue":"1","key":"B7","series-title":"Aviat Space Environ Med.","first-page":"3","article-title":"Brain magnetic resonance imaging anomalies in U-2 pilots with neurological decompression sickness","volume":"84","author":"Jersey SL","year":"2013","unstructured":"Jersey SL, Jesinger RA, Palka P. Brain magnetic resonance imaging anomalies in U-2 pilots with neurological decompression sickness. Aviat Space Environ Med. 2013; 84(1):3\u201311. 10.3357\/ASEM.3405.2013"},{"key":"B8","series-title":"Clin Neurol Neurosurg.","first-page":"9","article-title":"Patent foramen ovale and asymptomatic brain lesions in military fighter pilots","volume":"125","author":"Kang KW","year":"2014","unstructured":"Kang KW, Kim JT, Choi WH, Park WJ, Shin YH, Choi KH. Patent foramen ovale and asymptomatic brain lesions in military fighter pilots. Clin Neurol Neurosurg. 2014; 125:9\u201314. 10.1016\/j.clineuro.2014.07.011"},{"key":"B9","series-title":"Pol J Radiol.","first-page":"93","article-title":"Artifacts in magnetic resonance imaging","volume":"80","author":"Krupa K","year":"2015","unstructured":"Krupa K, Bekiesi\u0144ska-Figatowska M. Artifacts in magnetic resonance imaging. Pol J Radiol. 2015; 80:93\u2013106."},{"issue":"1","key":"B10","series-title":"Neurosurg Clin N Am.","first-page":"1","article-title":"Arteriovenous malformations: epidemiology and clinical presentation","volume":"23","author":"Laakso A","year":"2012","unstructured":"Laakso A, Hernesniemi J. Arteriovenous malformations: epidemiology and clinical presentation. Neurosurg Clin N Am. 2012; 23(1):1\u20136. 10.1016\/j.nec.2011.09.012"},{"issue":"1","key":"B11","series-title":"Nat Rev Dis Primers.","first-page":"15008","article-title":"Brain arteriovenous malformations","volume":"1","author":"Lawton MT","year":"2015","unstructured":"Lawton MT, Rutledge WC, Kim H, Stapf C, Whitehead KJ,  Brain arteriovenous malformations. Nat Rev Dis Primers. 2015; 1(1):15008. 10.1038\/nrdp.2015.8"},{"issue":"6","key":"B12","series-title":"J Neurosurg Pediatr.","first-page":"696","article-title":"Long-term endocrine outcome of suprasellar arachnoid cysts","volume":"19","author":"Lee JY","year":"2017","unstructured":"Lee JY, Lee YA, Jung HW, Chong S, Phi JH,  Long-term endocrine outcome of suprasellar arachnoid cysts. J Neurosurg Pediatr. 2017; 19(6):696\u2013702. 10.3171\/2017.1.PEDS16404"},{"key":"B13","series-title":"Intracranial arachnoid cysts in German military aircraft pilots.","author":"Lueling F","year":"2017","unstructured":"Lueling F, Zschommler Y. Intracranial arachnoid cysts in German military aircraft pilots. Flugmedizinisches Institut der Luftwaffe. F\u00fcrstenfeldbruck (Germany): German Air Force Institute of Aviation Medicine; 2017."},{"issue":"12","key":"B14","series-title":"Aviat Space Environ Med.","first-page":"1117","article-title":"Hyperintense white matter lesions in 50 high-altitude pilots with neurologic decompression sickness","volume":"83","author":"McGuire SA","year":"2012","unstructured":"McGuire SA, Sherman PM, Brown AC, Robinson AY, Tate DF,  Hyperintense white matter lesions in 50 high-altitude pilots with neurologic decompression sickness. Aviat Space Environ Med. 2012; 83(12):1117\u20131122. 10.3357\/ASEM.3395.2012"},{"issue":"7","key":"B15","series-title":"Neurology.","first-page":"638","article-title":"Lower neurocognitive function in U-2 pilots: relationship to white matter hyperintensities","volume":"83","author":"McGuire SA","year":"2014","unstructured":"McGuire SA, Tate DF, Wood J, Sladky JH, McDonald K,  Lower neurocognitive function in U-2 pilots: relationship to white matter hyperintensities. Neurology. 2014; 83(7):638\u2013645. 10.1212\/WNL.0000000000000694"},{"issue":"2","key":"B16","series-title":"Neurosurgery.","first-page":"195","article-title":"The prospective natural history of cerebral venous malformations","volume":"43","author":"McLaughlin MR","year":"1998","unstructured":"McLaughlin MR, Kondziolka D, Flickinger JC, Lunsford S, Lunsford LD. The prospective natural history of cerebral venous malformations. Neurosurgery. 1998; 43(2):195\u2013200. 10.1097\/00006123-199808000-00001"},{"issue":"1","key":"B17","series-title":"BMC Neurol.","first-page":"50","article-title":"The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging","volume":"14","author":"Meng G","year":"2014","unstructured":"Meng G, Bai C, Yu T, Wu Z, Liu X,  The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging. BMC Neurol. 2014; 14(1):50. 10.1186\/1471-2377-14-50"},{"key":"B18","series-title":"BMJ.","first-page":"b3016","article-title":"Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis","volume":"339","author":"Morris Z","year":"2009","unstructured":"Morris Z, Whiteley WN, Longstreth WT, Weber F, Lee YC,  Incidental findings on brain magnetic resonance imaging: systematic review and meta-analysis. BMJ. 2009; 339:b3016. 10.1136\/bmj.b3016"},{"key":"B19","series-title":"Diagnostic imaging: brain.","first-page":"174","article-title":"Arachnoid cyst","author":"Osborn AG","year":"2004","unstructured":"Osborn AG. Arachnoid cyst. In: Osborne A, Blaser S, Salzman K. Diagnostic imaging: brain. Salt Lake City (UT): Amirsys; 2004:174\u2013176."},{"key":"B20","series-title":"Diagnostic neuroradiology.","first-page":"284","article-title":"Intracranial vascular malformations","author":"Osborn AG","year":"1994","unstructured":"Osborn AG. Intracranial vascular malformations. In: Osborn AG. Diagnostic neuroradiology. Maryland Heights (MO): Mosby; 1994:284\u2013329."},{"issue":"2","key":"B21","series-title":"Neurosurg Focus.","first-page":"E7","article-title":"Arachnoid cysts: case series and review of the literature","volume":"22","author":"Pradilla G","year":"2007","unstructured":"Pradilla G, Jallo G. Arachnoid cysts: case series and review of the literature. Neurosurg Focus. 2007; 22(2):E7. 10.3171\/foc.2007.22.2.7"},{"issue":"10","key":"B22","series-title":"AJNR Am J Neuroradiol.","first-page":"1943","article-title":"Multiple brain developmental venous anomalies as a marker for constitutional mismatch repair deficiency syndrome","volume":"39","author":"Shiran SI","year":"2018","unstructured":"Shiran SI, Ben-Sira L, Elhasid R, Roth J, Tabori U,  Multiple brain developmental venous anomalies as a marker for constitutional mismatch repair deficiency syndrome. AJNR Am J Neuroradiol. 2018; 39(10):1943\u20131946. 10.3174\/ajnr.A5766"},{"key":"B23","series-title":"Diseases of the brain, head and neck, spine 2020\u20132023: diagnostic imaging, chapter 8.","first-page":"93","article-title":"Differential diagnosis of intracranial masses","author":"Smirniotopoulos JG","year":"2020","unstructured":"Smirniotopoulos JG, J\u00e4ger HR. Differential diagnosis of intracranial masses. In: Hodler J, Kubik-Huch RA, von Schulthess GK, editors. Diseases of the brain, head and neck, spine 2020\u20132023: diagnostic imaging, chapter 8. Cham (CH): Springer; 2020:93\u2013104."},{"issue":"3","key":"B24","series-title":"Aerosp Med Hum Perform.","first-page":"146","article-title":"Incidental finding prevalences in 3-Tesla brain and spine MRI of military pilot applicants","volume":"92","author":"S\u00f6nksen SE","year":"2021","unstructured":"S\u00f6nksen SE, K\u00fchn SR, Nobl\u00e9 HJ, Knopf H, Ehling J,  Incidental finding prevalences in 3-Tesla brain and spine MRI of military pilot applicants. Aerosp Med Hum Perform. 2021; 92(3):146\u2013152. 10.3357\/AMHP.5749.2021"},{"issue":"3","key":"B25","series-title":"Anticancer Agents Med Chem.","first-page":"291","article-title":"MRI contrast agents: current status and future perspectives","volume":"7","author":"Strijkers GJ","year":"2007","unstructured":"Strijkers GJ, Mulder WJM, van Tilborg GAF, Nicolay K. MRI contrast agents: current status and future perspectives. Anticancer Agents Med Chem. 2007; 7(3):291\u2013305. 10.2174\/187152007780618135"},{"issue":"2","key":"B26","series-title":"J Neuroradiol.","first-page":"74","article-title":"Brain and spine MRI artifacts at 3 Tesla","volume":"36","author":"Vargas MI","year":"2009","unstructured":"Vargas MI, Delavelle J, Kohler R, Becker CD, Lovblad K. Brain and spine MRI artifacts at 3 Tesla. J Neuroradiol. 2009; 36(2):74\u201381. 10.1016\/j.neurad.2008.08.001"},{"issue":"2","key":"B27","series-title":"Aviat Space Environ Med.","first-page":"158","article-title":"Cranial MRI as a screening tool: findings in 1,772 military pilot applicants","volume":"75","author":"Weber F","year":"2004","unstructured":"Weber F, Knopf H. Cranial MRI as a screening tool: findings in 1,772 military pilot applicants. Aviat Space Environ Med. 2004; 75(2):158\u2013161."}],"container-title":["Aerospace Medicine and Human Performance"],"original-title":[],"link":[{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/3\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/3\/article-p255.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/asma.kglmeridian.com\/downloadpdf\/journals\/amhp\/96\/3\/article-p255.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,25]],"date-time":"2025-02-25T00:02:06Z","timestamp":1740441726000},"score":1,"resource":{"primary":{"URL":"https:\/\/asma.kglmeridian.com\/view\/journals\/amhp\/96\/3\/article-p255.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":27,"journal-issue":{"issue":"3"},"URL":"https:\/\/doi.org\/10.3357\/amhp.6388.2025","relation":{},"ISSN":["2375-6314","2375-6322"],"issn-type":[{"value":"2375-6314","type":"print"},{"value":"2375-6322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}