July/August Issue 57 - Flipbook - Page 29
D4DRIVERS
MINISTROKES
A ministroke, also known as a Tia, or
Transient ischaemic attack, is caused by
a temporary disruption of the blood supply
to the brain. Symptoms are caused by a
blood clot in the artery which supplies the
brain, and when the clot moves the blood
supply resumes, and the symptoms resolve.
Strokes and Tia’s can cause one or more
of the following symptoms : weakness of
the face and body, loss of vision usually in
one eye, as well as speech problems, and
occasionally persistent vertigo.
Although the FAST campaign has increased
public awareness of the signs of a stroke,
there remains some public confusion over
the differences between a stroke and
ministroke, and the implications this has on
driving.
As a reminder the FAST acronym stands for
Face - Has it fallen on one side?
Arms - Can they raise them?
Speech - Is it slurred?
Time - If you notice any of these signs make
the call, Dial 999
The key difference between a stroke and
mini-stroke, is the time the symptoms last,
as a ministroke does not last as long as
a stroke. The effects of a mini-stroke only
last a few minutes to a few hours, and they
always fully resolve within 24 hours. It can
therefore impossible to tell which type of
stroke you are having in the early stages of
developing the symptoms, and you should
seek emergency assistance by calling for an
ambulance.
In terms of driving, the DVLA D4 form asks
whether there is a history of a previous
stroke or Tia, and specifically when this
occurred, whether there was single or
multiple strokes and if there was full
recovery. It also asks about whether an
ultrasound scan of the carotid artery of the
neck has been undertaken and if this shows
stenosis, known as narrowing, of the artery.
do increase your future risk of developing a
full stroke. This risk is greatest in the first few
days to months of having had a ministroke,
with there being about a 5% risk of developing
a full stroke within a month of having a ministroke. Strokes can lead to a multitude of
difficulties which make return to work more
challenging which can including weakness
of the body, difficulty with coordination and
mobility, fatigue, speech problems, cognitive
difficulties and depression.
Strokes affect people of all ages, with 1 in 4
affecting people of working age. Risk factors
include age, family history and ethnicity
which are unmodifiable risk factors which
are factors outside of your control, but more
importantly there are several lifestyle factors
which increase your risk including smoking,
diabetes, high blood pressure and high
cholesterol. By keeping active, maintaining
a healthy weight and lifestyle you can lower
your individual risk of developing mini-strokes
and strokes.
The implications of suffering a stroke or
Ministroke for group 2 license holders are
significant with the DVLA stating that you
must inform them immediately and you must
not drive this type of vehicle for at least one
year, with re-licensing being dependant on
individuals having no ongoing debarring
residual impairment and having satisfactory
medical investigation results. Medical
investigations which would allow relicensing
include having less than 50% narrowing of
In summary, it is important to remember
the carotid arteries, and cardiac assessment that Mini- strokes mimic the symptoms of
with treadmill exercise testing in some cases. a stroke, but are short-lived and last for
less than 24hours. It is important to seek
Most individuals having had a mini-stroke
urgent medical attention as you may need
will feel well with no physical restrictions,
clot busting medication to clear the artery,
and may feel that the DVLA rules are unduly and other treatment to lower your risk of
restrictive. The reason for restrictions
developing a subsequent stroke. A healthy
imposed by the DVLA includes the fact that
lifestyle will certainly lower the risks of this
mini-strokes can recur unpredictably and
potentially devastating condition.
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