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Old 19th May 2017, 07:08   #1 (permalink)
Thread Starter
Join Date: Apr 2015
Location: Hong Kong
Posts: 31
CASA class2 head injury more than 10 years ago


I am applying CASA medical class 2.

I reported I had a head injury more than 10 years ago. I had no surgery but had some imaging and stayed in the hospital for 10 days.

It is reasonable that CASA asked for further information.

As the accident was long time ago, the MRI image was lsot.

I attach all the records the hospital has kept for the accident in 2004 including:

I provided CASA the following documents.

1. Emergency Department Report
2. Discharge summary
3. Consultation summary

It is anticipated that I have to get some tesst and I found myself suit in the clause in Designated Aviation Medical examiner's Handbook(2004) p.2.5-14.

2. Applicants with PTA from 30 minutes to 24 hours, with a normal MRI and EEG, are acceptable after 12 months. If a seizure occurred in the first week after trauma in ana dult, a longer interval before re-licensing is required. Such cases are assessed individually.

Was anyone in the similar situation?
What type of EEG did you have? What did your specialist have to write in the report? Did you do any imaging?
pilotwannabehk is offline   Reply With Quote
Old 19th May 2017, 08:15   #2 (permalink)
Join Date: Jan 2012
Location: Below transition level
Posts: 226
Hi there,

I have had similar, I suffered a head injury in 2005 when some kind person knocked me off my bike while I was out training and left me unconscious in the road. At the time I was concussed and had a small subdural haematoma visible on the head CT but was this was without sufficient mass to allow it to be treated conservatively. I spent approx 2 weeks in hospital due to other musculo-skeletal injuries and was then discharged, I did not receive any neuro follow-up. Subsequently I had no long term issues related to the above and am fit and healthy.

I obtained my Class 2 initial in 2010 from the UK CAA. At the time I needed to provide a report by a consultant neurologist who reviewed my history. The CAA AMS subsequently granted me a Class 2 initial without restriction.

In 2012 I went to obtain my Class 1 initial with the UK CAA. I was again required to submit a further neurologists report along with a recent brain MRI. This show absolutely no evidence of injury and was described by the radiologist as "very satisfactory". The neurologist's report however raised the issue of PTE (post traumatic epilepsy) and based on several studies, estimated by risk of developing PTE to be <0.5% per annum, decreasing with time. The CAA/EASA require a risk of <0.1% for an unrestricted Class 1 so I have found myself with a long term OML. I have told that this can be reviewed again in 2020, this will be 15 years post accident.
Fostex is offline   Reply With Quote
Old 19th May 2017, 08:49   #3 (permalink)
Thread Starter
Join Date: Apr 2015
Location: Hong Kong
Posts: 31
When considering recertification, a residual risk of PTE of 1% or less is acceptable, given
that the prevalence of epilepsy in the community is 0.33%.
Conditions that require careful assessment and which most commonly result in a "fail"
assessment are: epilepsy, intracerebral haematoma, , persisting CSF fistula, primary open
cerebral laceration, and the presence of any significant permanent neurological deficit.
Seems CASA's standard is not as strict as CAA, the PTE required is less than 1%
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Old 19th May 2017, 10:50   #4 (permalink)
Join Date: Jan 2012
Location: Below transition level
Posts: 226
Now that is fascinating, I wonder where they get the 0.33% figure. A lot of medical literature in the area of PTE would dispute that.

Then again, the real answer is that it is a calculated statistical risk and no one really knows!

Last edited by Fostex; 19th May 2017 at 11:03.
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