Can you drive a car or truck after having a stroke or TIA?

Around ten thousand people a year have a stroke or a transient ischaemic attack (a mini-stroke) every year. A stroke can be caused by a blockage, such as a blood clot, stopping blood flow to part of the brain, or if a burst blood vessel bleeds into the brain. That part of the brain stops working and starts to die, which can affect a person’s ability to move, talk, see and comprehend what is going on around them.

Many stroke victims go on to make a full recovery. Some are left with residual mental issues such as difficulty remembering or thinking, or ongoing fatigue. Others are left with physical limitations such as the inability to control one side of the body.

What happens after a stroke?

If you have visited a person who has had a stroke, it’s likely you will have noticed that their thinking and cognition are hampered. They may also have less control over one side of their body.

Over a period of several weeks, any swelling in the brain will diminish and some of the impacted cells will start to function again. For any parts of the brain too badly damaged, other parts of the brain need to learn how to perform those functions, if possible. This can take several months or more, and some parts may never recover. Some patients can continue to recover for several years.

How does a stroke or TIA affect your driving?

A person who has had a stroke must not drive a motor vehicle until they have been cleared by a doctor. Depending on how the stroke has affected the patient, the patient may feel like they want to drive, but not be aware of their limitations.

Initially, a doctor will conduct an assessment regarding the patient’s fitness to drive. If they decide the patient is unfit to drive, the patient can seek a second opinion at their own expense. If the second doctor also deems the patient unfit to drive, the patient must surrender their driving licence or otherwise make a commitment not to drive. The doctor may also notify Waka Kotahi NZ Transport Agency who may review the licence and could take it away.

If the doctor is unsure, they will recommend an assessment. It will be performed by a specialist occupational therapist or specialist driving instructor; not all stroke victims will need to have this assessment.

Can you drive a car or ride a motorbike after a stroke?

Assuming you have clearance from a doctor, you will be able to continue driving a car or riding a motorbike. The minimum recommended timeframe is one month, including for TIAs. If multiple TIAs are experienced, the patient must wait three months, providing the conditions has been adequately investigated and treated. There should be no residual disability that interferes with a person’s ability to operate the vehicle.

It is possible to have adaptations made to a vehicle to accommodate a change in the abilities of a driver; the occupational therapist will discuss these with the patient.

Can you drive a truck, bus or other passenger vehicle after a stroke?

In general, licences for driving heavy vehicles or carrying passengers are not issued after a stroke unless there’s been a full and complete recovery with no suggestion or recurrence over a period of three years, a supporting physician or neurologist’s report is supplied, and the Transport Agency’s Chief Medical Adviser has reviewed the case.

In the case of a TIA, it might be OK to drive again after 6 months of no evidence of further TIAs. Patients with multiple TIAs must not drive a heavy vehicle, or one requiring a P or V endorsement.

Can you drive an excavator, forklift, loader or other similar vehicle after a stroke?

You must wait at least one month after a stroke or TIA and must be cleared by your doctor. There should be no residual disability that would interfere with your ability to operate the vehicle.

Can you carry dangerous goods in a vehicle using a D endorsement after a stroke?

If the vehicle is a light vehicle (class 1 or class 6), then it is possible to carry dangerous goods, although you should ensure that you have refreshed your knowledge related to carrying dangerous goods.

Can you work as a driving instructor or testing officer after having a stroke?

In general, if you require an I or O endorsement to operate the vehicle, then you will be able to continue as an instructor or testing officer after 6 months since the TIA, as long as you have not experienced additional TIAs or a stroke. If you have had a stroke, you must get permission from NZTA, as per a heavy vehicle licence.

What happens after a stroke that makes driving difficult?

The ongoing symptoms of a stroke which cause issues for drivers and machine operators include:

• Fatigue – stroke patients can feel extremely tired despite getting a lot of sleep.
• Weakness – stroke patients can experience weakness in the arm or leg that was affected by the stroke, and this could extend to temporary paralysis or muscle spasms.
• Cognition – driving requires ongoing concentration, multitasking and decision making. A driver might experience a general reduction in these abilities. Also, while a driver might cope for a short period of time behind the wheel, mental stamina can be affected.
• Memory – a driver might find it difficult to remember important information such as destination, where they parked their car, the last road sign they saw, and key road rules.
• Vision – stroke can cause double vision or blurred vision, loss of central vision in one or both eyes, and visual field loss.