2010 BC Guide in Determining Fitness to Drive

The prognosis for recovery following a CVA is related to the severity of the CVA and how muchof the brain has been damaged. Most functional recovery occurs within the first two monthsfollowing a CVA.The risk of a subsequent CVA is approximately 4% per year, with a 10 year cumulative risk of43%. In the first six months following a CVA, the risk of a subsequent CVA is approximately9%.Cerebral aneurysmA cerebral aneurysm is the localized dilation or ballooning of a cerebral artery or vein resultingfrom weakness in the wall of the affected vessel. Most cerebral aneurysms have no associatedsymptoms until they become large or rupture. The majority (50 to 80%) remain small and do notrupture.Symptoms associated with larger aneurysms include: sudden severe headache nausea and vomiting visual impairment, and loss of consciousness.The risk of rupture increases with the size of the aneurysm. A rupture results in subarachnoid orintracerebral hemorrhage, leading to alterations in consciousness including: syncope seizures visual impairment, and respiratory or cardiovascular instability.Treatment of unruptured cerebral aneurysms is controversial. Treatment options includeobservation and surgical procedures to prevent blood from flowing into the aneurysm. Risks ofsurgery include possible damage to other blood vessels, potential for aneurysm recurrence andrebleeding, and post-operative CVA. Successful surgery reduces the risk of rupture.20.2 Prevalence and incidence of cerebrovascular diseaseTransient ischemic attackThe results of a survey published in 2000 by the National Stroke Association found that half amillion adults (18 years of age and older) in Canada had been diagnosed with a TIA. Apopulation-based study in Alberta found the age-adjusted incidence of TIA to be between .04%and .07% (44 and 68 per 100,000) annually.The risk factors for a TIA are similar to those for CVA (see below).240