Lacunar Stroke

[Mustang01]

I am a (relatively) young pilot who recently suffered a Lacunar Stroke (aborted via tPA administration). As a result of very quick treatment, I have no physical or cognitive deficit. Will I have to go through the entire FAA Completed Ischemic Stroke protocol and apply for SI, even though the stroke did not "complete"?

 

[Gary F]

I am a (relatively) young pilot who recently suffered a Lacunar Stroke (aborted via tPA administration). As a result of very quick treatment, I have no physical or cognitive deficit. Will I have to go through the entire FAA Completed Ischemic Stroke protocol and apply for SI, even though the stroke did not "complete"?

Not an AME but if the stroke was aborted by thrombolytics I doubt that the FAA would treat this any differently than a completed stroke. The question is what is the risk of a future event and they will want a comprehensive evaluation to detect any subtle defects. Dr. Bruce or a senior AME will need to help you. Get a consult outside of the FAA medical application process before you even think of applying.

 

[Mustang01]

I fully get the need for the work ups...assess and mitigate risk factors. My AME and I have a plan to get all of them. I understand a 12-24 month (minimum) recovery period is mandatory. Any idea if that is ever excepted? If so, would thrombolytic abortion be a rationale for shorter recovery period if the work ups are otherwise good or successfully treated?

 

[Gary F]

I fully get the need for the work ups...assess and mitigate risk factors. My AME and I have a plan to get all of them. I understand a 12-24 month (minimum) recovery period is mandatory. Any idea if that is ever excepted? If so, would thrombolytic abortion be a rationale for shorter recovery period if the work ups are otherwise good or successfully treated?

Again, not an AME. I think it's that fact that you needed thrombolytic therapy that will be the determining factor. This is fairly drastic treatment. It is not expected to abort a stroke but to limit the damage. If your neurologist can make a case you really were not having a stroke and the treatment was inappropriately used by an overzealous emergency physician you might get off easier. You really need to track down and hire Dr. Bruce to review your records and give competent guidance.

 

[Unregistered]

I'm in a similar position to the OP (recently had an ischemic stroke, quickly treated with tPA, no residual cognitive or physical impairment) and had some questions along the same lines. I'm already assuming that I'll need to go through the full workup to get a special issuance, but I have a few questions about what to do in the meantime.

- Am I correct that I shouldn't start the application process or discuss the matter with the FAA until all my ducks are in a row (including the amount of time without further incident) for the special issuance?
- What's the best way to "Get a consult outside of the FAA medical application process" as the post above suggests?

I'm also curious about what my options are to stay somewhat proficient during that mandatory observation time. I assume that I should be able to at least fly with a CFI/CFII, and it looks like I may be able to fly an LSA using the driver's license medical option IF my treating physician doesn't think that my condition is likely to impair the safety of the flight, and if I don't have a certificate or special issuance denied in the meantime (which is the reason not to talk to the FAA until getting everything lined up). Is this correct? Is flying with another pilot also an option as long as the other pilot is acting as PIC?

 

[poadeleted20]

I'm in a similar position to the OP (recently had an ischemic stroke, quickly treated with tPA, no residual cognitive or physical impairment) and had some questions along the same lines. I'm already assuming that I'll need to go through the full workup to get a special issuance,

The person who can turn your assumptions into facts is Dr. Bruce Chien, whom you can find either on the AOPA Forums or via his website.

but I have a few questions about what to do in the meantime.

- Am I correct that I shouldn't start the application process or discuss the matter with the FAA until all my ducks are in a row (including the amount of time without further incident) for the special issuance?

Yes.

- What's the best way to "Get a consult outside of the FAA medical application process" as the post above suggests?

Ask Bruce.

I'm also curious about what my options are to stay somewhat proficient during that mandatory observation time. I assume that I should be able to at least fly with a CFI/CFII, and it looks like I may be able to fly an LSA using the driver's license medical option IF my treating physician doesn't think that my condition is likely to impair the safety of the flight, and if I don't have a certificate or special issuance denied in the meantime (which is the reason not to talk to the FAA until getting everything lined up). Is this correct?

All correct.

Is flying with another pilot also an option as long as the other pilot is acting as PIC?

Yes it is. Of course, if you have any question about your skill level or proficiency as a result of your layoff, it would be wise to fly only with an instructor until you feel you're back "up to speed" since the average Private Pilot is not trained/certified to evaluate your performance, decide when intervention is necessary, and then intervene is a safe and effective manner. And, of course, you can log the time as PIC time and the events for recent experience since you'd be the sole manipulator of the controls of an aircraft for which you are rated even if you're not acting as PIC. That could be significant when you get your SI and want to be flying on your own again.

 

[Unregistered]

Thanks, this is very helpful.