When can you drive again after a stroke or brain injury?

Why is driving affected after a stroke or brain injury?

Driving is one of the most complex everyday tasks. It requires seeing hazards on both sides, dividing attention between the road, mirrors and instruments, reacting quickly, judging speed and distance, planning manoeuvres and controlling the vehicle with both arms and legs. A stroke or brain injury can affect any of these.

Problems such as a loss of half the visual field, neglect of one side, slowed thinking, poor concentration, impulsivity or seizures may not be obvious in daily life at home but can make driving unsafe. People are not always aware of these changes in themselves.

What are the rules after a stroke?

Rules differ between countries, so drivers should check with their local licensing authority. As an example, UK guidance states that car and motorcycle drivers must not drive after a stroke and may resume after one month if there has been satisfactory clinical recovery 1. The licensing agency must be informed if there is a residual neurological problem after one month, particularly visual field defects, cognitive problems or impaired limb function 1.

For bus and lorry drivers in the UK, the licence is refused or revoked for one year after a stroke or transient ischaemic attack, and relicensing depends on there being no disabling residual impairment and no other significant risk factors 1. Seizures after a stroke bring separate rules.

What are the rules after a traumatic brain injury?

UK guidance for car and motorcycle drivers after a traumatic brain injury states that they must not drive and may need to notify the licensing agency. Relicensing is usually considered after 6 to 12 months, depending on features such as seizures, post-traumatic amnesia lasting more than 24 hours and bleeding or bruising seen on scans 1. Satisfactory recovery with no visual field defects or cognitive impairment likely to affect driving is required 1.

After a milder head injury with full recovery and no seizures, driving can often resume without notifying the agency, but specific criteria apply. Doctors can advise on individual circumstances.

How is fitness to drive assessed?

Doctors review vision, including visual fields, movement, sensation, seizures, medicines and thinking skills. Rehabilitation teams may use cognitive tests of attention, processing speed and planning. These tests help but cannot fully predict driving performance.

When there is uncertainty, a specialist driving assessment centre can carry out an on-road assessment with a qualified instructor and an occupational therapist. Stroke and head injury guidance supports considering driving as part of rehabilitation planning 23.

Can a car be adapted?

People with weakness in one arm or leg may be able to drive with adaptations such as automatic transmission, a steering wheel spinner knob, a left-foot accelerator or hand controls. A driving assessment centre can recommend suitable adaptations and training.

Adaptations do not overcome problems with vision, attention or judgement, which must be adequate for safe driving regardless of the vehicle.

What if driving is not possible?

Losing the ability to drive affects independence, work and social life, and it can be a major loss. Planning alternatives such as public transport, community transport schemes, taxis and help from family reduces isolation.

Rehabilitation may help people regain skills needed for driving over time, and reassessment is often possible later. Occupational therapists can help with travel training and alternative ways to stay active in the community.

What are the risks of driving too soon?

Driving before recovery is adequate increases the risk of collisions that can harm the driver and others. In many countries, driving against medical advice or without informing the licensing authority when required can invalidate insurance and have legal consequences.

Families who are concerned about safety should discuss this with the doctor. It is better to wait for proper assessment than to risk an accident.

Frequently asked questions