Problem

A young-adult male patient unexpectedly collapsed on an international flight. After the airplane landed, he was rushed to a local hospital for evaluation. Because his level of consciousness continued to worsen, a cerebral computed tomography (CT) exam was performed to evaluate his condition. The radiologic findings were bilateral globus pallidus hypodensity consistent with hypoxic brain injury (see Figure). This type of diagnosis is unusual considering that the patient was a young, healthy man who had no apparent delusional or physical abnormalities upon entering the airplane just a few hours earlier. What could have caused his sudden hypoxic brain injury?

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