A stroke is a medical emergency. When an artery to the brain gets blocked or ruptures, brain cells in the area die from lack of oxygen. This can lead to death or permanent injury. Symptoms or warning signs of stroke include:
- sudden blurred or decreased vision in one or both eyes
- numbness, weakness or paralysis in the face, arm or leg
- difficulty speaking or understanding
- difficulty swallowing, and severe headache.
Your doctor may describe your stroke as either a cardiovascular accident (CVA) or transient ischaemic attack (TIA: better known as a mini-stroke).
The signs of stroke may occur alone or in combination and they can last a few seconds or up to 24 hours and then disappear. The risk of a repeat event is far higher in some patients than others.
The effect of the condition on aviation
- risk of impaired attention, concentration, memory
- greater risk of seizure
- brain injury as a result of stroke leading to dementia and physical impairment
- patients with existing conditions like cardiovascular disease, diabetes or atrial fibrillation (AF) tend to fare worst
- a stroke can cause sudden loss of brain function or lead to sudden death
- a stroke puts you in significant danger of having another stroke or a heart attack.
The effect of treatment on aviation
- Some drug therapies can limit your G-tolerance.
- Antiplatelets (medicines that stop blood cells from clotting) can cause bleeding in the brain.
Implications for pilots and controllers
- There is a mandatory 12 month grounding period in cases of stroke. If you suffer a stroke you must ground yourself immediately and tell your Designated Aviation Medical Examiner (DAME) or CASA.
- If you are diagnosed with a CVA you will need to provide the following to CASA as soon as possible:
- hospital admission notes
- results of brain imaging
- results of blood tests
- hospital discharge letter
- initial neurologist assessment.
- In many cases CASA will be able to rely on these reports alone to predict your chances of future certification, before the mandatory 12 month grounding period is complete.
- Where your future health is less certain, CASA may need to see a follow up neurologist report and in some cases a cardiologist report, after the completion of the 12 month mandatory grounding period.
Approach to medical certification
You will need to prove you have had no further strokes or other signs of neurological disorder for 12 months if you wish to apply for certification. It may not be possible for CASA to ever re-certify you if your stroke caused permanent impairment, or if you doctor finds you are likely to suffer another stroke or a myocardial infarction (heart attack).
CASA may need you to undertake annual cerebrovascular and cardiovascular risk assessments even where it can reissue your certificate. You may face permanent Multi-crew (Class 1) or Safety Pilot (Class 2) restriction in the interests of aviation safety.
More likely to be certified
You are more likely to be certified or re-certified if:
- your doctors declare your treatment a success and can find no other significant risk factors or other health issues
- your stroke was caused by physical trauma to the neck, such as:
- a blunt injury
- strangulation or manipulation
- a connective tissue disorder affecting your blood vessels: for example, if your doctors tell you that you suffered an artery dissection CVA
- you are less than 50 years of age.
Less likely to be certified
You are less likely to be certified or re-certified if:
- your doctors find you are at high risk of suffering another stroke or heart attack
- you are 50 years of age or older
- you suffer permanent and significant functional impairment because of injury to your brain resulting from the stroke
- you have significant coronary artery disease.
You are unique
Every stroke is different. Each person affected by stroke will face unique problems and have different needs. How you are affected by a stroke depends on where in the brain the stroke happens and how big the stroke is. A stroke on the right side of the brain tends to create problems on the left side of the body. A stroke on the left side of the brain causes problems on the right side of the body. Some strokes happen at the base of the brain and can cause problems with eating, breathing and moving.
You will need to seek medical advice about this condition.
For further information see: