Strokes and Truck Driving

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December 18, 2012
Edward Smith

There are guidelines in place as to when a commercial driver can return to driving trucks and similar vehicles after sustaining a stroke or TIA. A TIA is sometimes called a “mini-stroke”. It is actually a temporary stroke that has all the same symptoms of a stroke but disappears after 24 hours or less. A completed stroke involves paralysis and loss of sensation on one side of the body, associated with language difficulty and other neurological symptoms.

The vast majority of strokes occur because of blockages of the blood vessels leading to the brain. The blood vessel can be as big as the carotid artery or one of the smaller side branches leading to a smaller part of the brain. The rest of strokes or TIAs are from bleeding of a blood vessel within the brain. There are also small lacunar infarcts, which are multiple tiny areas of the brain that affect the central part of the brain.

Patients with stroke and TIA are at their worst in the beginning of the stroke. They gradually improve to a certain level of functioning, which can be profound or nearly normal. Those that are normal or nearly normal after the neurological event certainly have the ability to drive; however, there are concerns about additional neurological events and those that drive trucks and other commercial vehicles are at particular risk because of the type of vehicle they drive and the risk of injuring other people on the road.

In one study, they looked at the present guidelines for drivers of commercial motor vehicles such as trucks as to when they can return to work driving truck after a stroke or TIA. There are updated recommendations from the original 1988 recommendations.

The US Department of Transportation’s Federal Motor Carrier Safety Administration looked at the literature from 1988 through January 2008 to see if they could update the recommendations for commercial drivers driving after stroke or TIA. What they found was that patients who suffered from a TIA were at risk for suffering from a major stroke.

Those with past strokes are at an increased risk of suffering from a traffic accident.
There were no studies available that gave direct predictions as to how much greater is the risk of driving with stroke or TIA when compared to those who did not have these neurological events. In other words, they don’t know the exact risk of driving with a TIA or stroke. There is good evidence, however, to indicate that certain neuropsychological testing is available that can identify those at risk of driving commercial vehicles after a stroke. TIA patients, by definition, have no symptoms after their TIA has resolved but are at a greater risk for developing another TIA or a stroke while driving.

The expert panel looking into the risk of driving commercial vehicles after a TIA or stroke and recommended that the driving of commercial vehicles be discontinued for one year after either a TIA or stroke and that the patient, upon wishing to resume driving a commercial vehicle, undergo and successfully complete a thorough neurological assessment, including neuropsychological testing and testing of their skills on the road.