Stroke and TIA guidance
When there is no doubt about a diagnosis of Transient Ischaemic Attack (TIA) or Stroke and the cause is likely to be of atherosclerotic origin, no form of initial certification is possible and recertification is unlikely. This is because the epidemiological studies show that the risk of a future atherosclerotic event will always exceed 1% per annum, usually by a considerable margin. Certification after a stroke due to a spontaneous cerebral haemorrhage will not usually be possible for the same reasons. In young patients (under 45 years) where no atherosclerotic disease can be shown there may be circumstances in the absence of generalised arterial disease, for example carotid or vertebral arterial dissection where some form of certification may be possible after a period of 6 to 12 months grounding if the risk of recurrence is acceptably low.
Re-certification following a TIA is subject to the absence of certain underlying abnormalities and disease and demonstrated control of specified risk factors. An age limit has been set because of the importance of age as a prognostic factor.
Unacceptable co-existing conditions:-
Demonstrated Control of the Following Risk Factors:-
Investigations That Shall be Required:-
Investigations That May be Required:-
When all reports have been received Class 1 applicants should be referred to the AMS and Class 2 applicants shall be assessed in consultation with the AMS. The following time periods are given for guidance.
|Type of TIA||Class 1 unrestricted||Class 1/OML||Class 2 unrestricted||Class 2/OSL|
|A Fugax *||N/A||1 year||1 year||6 months|
|Non-recurrant **||2 years||1 year||1 year||6 months|
|Other ***||N/A||2 years||2 years||1 year|
Annual cardiological review with exercise tolerance test.