Stroke or TIA

Your step-by-step plan

1. 1

   Step 1: The recovery period

   How long the table sets before anything is submitted for FAA review.

   The table's required recovery period, met before anything is submitted for FAA review.

   Required recovery period

   • 2 yearsCortical stroke or TIA
   • 1 yearSub-cortical stroke

   A known, corrected cause

   If the specific cause of a TIA or subcortical stroke is known and corrected, it may be considered case by case sooner than one year. Cortical strokes typically require 2 years, regardless of cause.

   Show the FAA's words: The recovery period

   Required recovery period: • Cortical stroke or TIA: 2-year recovery • Sub-cortical stroke: 1-year recovery

   …Once the required recovery period has been met, submit the following for FAA review:

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   Note: If the specific cause of a TIA or subcortical stroke is known and corrected (e.g., high-grade carotid stenosis fully treated or PFO with known acute venous clot fully treated), these may be considered on a case-by-case basis sooner than one year. Cortical strokes typically require a 2-year recovery period, regardless of cause.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

2. 2

   Step 2: Neurological evaluation and brain MRI

   From the treating neurologist, and imaging from the previous 12 months.Two things to bring

   • Neurological evaluation

     Within 90 days before the exam

     A detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation, from a clinic visit with your treating neurologist, no more than 90 days before the exam.

   • Brain MRI

     A brain MRI performed within the previous 12 months.

     New imaging may be required after FAA physician review.

     How it is sent

     • The interpretive report on paper
     • The images on CD in DICOM readable format, with a file named 'DICOMDIR' in the root directory of the CD-ROM
     • The CD verified to display the images before sending
     • A copy of all films kept, as a safeguard if lost in the mail

   Show the FAA's words: Neurological evaluation and brain MRI

   1. A detailed neurological evaluation that meets FAA Specifications for Neurologic Evaluation generated from a clinic visit with the treating neurologist no more than 90 days before the AME exam.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   2. Brain MRI performed within the previous 12 months. New imaging may be required after FAA physician review.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   Submit the interpretive report on paper and imaging on CD in DICOM readable format (there must be a file named 'DICOMDIR' in the root directory of the CD-ROM). Please verify the CD will display the images before sending. Retain a copy of all films as a safeguard if lost in the mail.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

3. 3

   Step 3: Hospital records and other tests

   Records from the event, the cardiac monitor, and testing already done.Three things to bring

   • Hospital records from the event

     The hospital records from the event.

     They include

     • Admission history and physical
     • Hospital discharge summary
     • Emergency Medical Services (EMS) or ambulance run sheet, if applicable
     • Hospital consultant reports, such as neurology, cardiology or internal medicine
     • Lab reports
     • Operative or procedure reports, if applicable
     • Radiology reports for all diagnostic imaging performed

     Not these

     • Not: Patient portal notes or an after visit summary (AVS), typically not sufficient
     • Not: Flowsheets, nursing notes, physician orders or medication administration records

   • Cardiac monitor results

     The cardiac monitor results the table lists.

     By case

     TIA

     A current 30-day cardiac event monitor, such as a Zio patch or implanted loop recorder (ILR)

     Implanted cardiac monitor placed, or a cryptogenic stroke

     At least six (6) months of device reports

     ILR currently implanted

     Data from implantation to the most recent interrogation

   • Other testing already performed

     If already performed.

     If already performed.

     Any of these, if already performed.

     New testing should not be obtained for aeromedical purposes until requested by FAA physicians.

     The table lists

     • Copies of all previous imaging, such as CT, MRI, MRA or other radiological tests
     • Carotid ultrasound, such as post procedure carotid endarterectomy
     • Transthoracic echocardiogram (TTE)
     • Cardiovascular evaluation (CVE), which may be in the hospital records
     • Stress test
     • Holter monitors performed since the event
     • Not: A carotid ultrasound in place of an MRA or CTA

   Show the FAA's words: Hospital records and other tests

   3. Hospital records from the event: • Admission History and Physical; • Hospital discharge summary. (Typically, the patient portal notes or after visit summary (AVS) printed from an electronic medical record are NOT sufficient for pilot medical certification purposes.); • Emergency Medical Services (EMS)/ambulance run sheet, if applicable; • Hospital consultant report(s) (e.g., neurology, cardiology, internal medicine, or other specialists); • Lab report(s);

   …• Operative/procedure report(s), if applicable; • *Radiology report(s). The interpretive report(s) of all diagnostic imaging (CT Scan, MRI, X-ray, ultrasound, or others) performed. • DO NOT submit miscellaneous hospital records such as flowsheets, nursing notes, physician orders, and medication administration records.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   4. Cardiac Monitor • TIA - Results of a current 30-day cardiac event monitor such as a Zio patch or implanted loop recorder (ILR). • If an implanted cardiac monitor was placed, OR if a cryptogenic stroke, submit a minimum of six (6) months of device reports. • If ILR is currently implanted, submit data from implantation to the most recent interrogation.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   5. Any other testing below, if already performed. New testing should not be obtained for aeromedical purposes until requested by FAA physicians. (See note on next page regarding additional testing.) • *Imaging. Copies of all previous imaging such as CT, MRI, MRA, or other radiological tests; • Carotid ultrasound such as post procedure carotid endarterectomy. A carotid ultrasound is NOT acceptable in place of an MRA or CTA; • Transthoracic echocardiogram (TTE); • Cardiovascular Evaluation (CVE). (This may be found in hospital records as many are completed during the hospital stay.); • Stress test; and • Holter monitors performed since the event.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

4. 4

   Step 4: If the FAA asks for more

   Testing FAA physicians may require case by case after reviewing Row A.Two things to bring

   • Neuropsychological evaluation

     Only if FAA physicians request it.

     Only if FAA physicians request it.

     A neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment, from a clinic visit with your treating neuropsychologist.

     In some cases, such as very small stroke in non-eloquent area, it may be reduced or waived after FAA review.

   • Hypercoagulopathy panel

     Only if FAA physicians request it.

     Only if FAA physicians request it.

     A comprehensive hypercoagulopathy panel.

     To include

     • Factor V Leiden mutation
     • PT and INR
     • PTT
     • Antithrombin III
     • Protein S free antigen
     • Activated protein C level
     • Prothrombin (Factor II) G20210A gene mutation
     • Homocysteine level
     • Antiphospholipid antibodies: lupus anticoagulant, anticardiolipin antibodies, beta-2 glycoprotein antibodies

   Show the FAA's words: If the FAA asks for more

   1. Neuropsychological evaluation that meets FAA Specifications for Neuropsychological Evaluations for Potential Neurocognitive Impairment from a clinic visit with the treating neuropsychologist. In some cases, such as very small stroke in non-eloquent area, this may be reduced or waived after FAA review.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   2. A comprehensive hypercoagulopathy panel to include the following test results: • Factor V Leiden mutation • PT and INR • PTT • Antithrombin III • Protein S free antigen • Activated protein C level • Prothrombin (Factor II) G20210A gene mutation • Homocysteine level • Antiphospholipid antibodies: • Lupus anticoagulant • Anticardiolipin antibodies • Beta-2 glycoprotein antibodies

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.

   ADDITIONAL TESTING: Due to the complex etiology of strokes, once the initial information (Row A) is reviewed by the FAA, the items below may be required on a case-by-case basis. Additional testing should not be obtained until requested by FAA physicians.

   FAA source: Stroke (CVA) or Transient Ischemic Attack (TIA). FAA date 26 April 2023; checked by Crosscheck 14 October 2026.