Driving After A Stroke

After experiencing a stroke, whether it is a mini-stroke (transient ischemic attack, or TIA) or a full-blown stroke (cerebrovascular accident, or CVA), life can be complicated. The event itself was scary, and all of life’s focus shifted first to survival, and then to getting home from the hospital. Unfortunately, the challenges do not stop there. There are often deficits to overcome, such as weakness, difficulty speaking and mobility problems. This is true not only in the home but on the road as well. Things they once took for granted, like holding a steering wheel, paying attention to mirrors, or safely judging the distance to an intersection may now seem nearly impossible.

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What is a stroke?

Your brain needs two main things to function: sugar and oxygen. These are carried to the brain through the bloodstream. When your brain is unable to access these nutrients, its cells quickly begin to die, and a patient can almost immediately begin to suffer impairments.

The first type of stroke is an ischemic stroke. The word “ischemic” means having an inadequate supply of blood as the result of an obstruction in the arteries. This often occurs in people with a history of atherosclerosis or cardiovascular disease and is usually associated with the narrowing of the arteries due to a buildup of plaque.

The second type of stroke is a hemorrhagic stroke. The word “hemorrhagic” basically means to bleed. In this form of stroke, vessels in the brain burst as the result of illness (high blood pressure, genetic disorders) or injury to the brain.

How can a stroke affect my ability to drive?

Regardless of which type of stroke a patient experiences, it can hinder one’s ability to drive a motor vehicle.  For some, these challenges can be minor and quickly overcome with minimal rehab, but for others, they can be debilitating and necessitate that the patient gives up driving permanently. Many will fall somewhere in between on this spectrum.

Depending on which area of the brain is affected by the stroke, a patient may experience a variety of complications. As they relate to driving, these fall into three main areas: Cognitive impairment, physical impairment, and visual impairment.

How a Stroke Affects Cognitive Abilities

  1. Difficulty reading and comprehending road signs, recognizing locations, or remembering routes.
  2. May forget where they are going and fail to recognize hazards in the road or slow down for pedestrians.
  3. Difficult for them to concentrate or cope with multiple stimuli, such as mirrors, oncoming traffic, and weather.
  4. Slower response times or have more difficulty solving problems, such as who has the right of way at a four-way stop or how to respond to construction detours.
  5. May have problems telling their left from their right, or accidentally move the car in the opposite direction they intend.
  6. Also possible that they will have problems speaking and understanding speech. This can be dangerous if they become lost and cannot communicate, or if they are pulled over by police and respond incorrectly.

How a Stroke Affects Physical Abilities

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  1. Weaker hands and be unable to safely grasp the steering wheel or make quick arm movements to react to changes in traffic.
  2. Weak legs may make it difficult to apply appropriate pressure on the gas or brakes.
  3. Less control over their trunk and be unable to maintain a safe, seated position without slumping forward or to one side.
  4. Difficulty turning their head and look over their shoulder to check for cars when changing lanes.
  5. May lose fine motor movements and have difficulty grasping the keys or adjusting knobs and buttons in the car.

How a Stroke Affects Visual Abilities

  1. Peripheral vision may be impacted, making it more difficult to see vehicles passing them or approaching from the sides.
  2. May lose vision in one of their fields, making it difficult to see things above or below a certain level, or a certain side.
  3. Depth perception may also decline, making it harder to judge the distance between them and intersections or other vehicles.
  4. May have a delay in processing the information their eyes take in or loss of function in the muscles of the eye which can limit ocular motion.
  5. May also experience a change in their visual acuity and need new corrective lenses.

What Next Street Looks For When Assessing

Every driver has unique needs after a stroke. That is why we work individually with each patient to determine what their particular deficits are, and what they can do to maximize the possibility of driving again.

After a patient has suffered a stroke, we will evaluate them in several areas to evaluate their prospects of driving again. We will check the patient’s vision, assess how perceptive they are to stimuli, and measure the speed at which they react to stimuli. We will also help determine how well they are physically able to function in the different ways needed to operate a motor vehicle. We check how well they can move their joints and test their balance and reflexes. Finally, we will give them a behind-the-wheel evaluation.


Want to read and learn more?

Check out the Driver Rehab blog to learn more about driving while aging.

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