Choosing to Drive After a Stroke

Stroke survivors drove again without having their driving skills evaluated

(RxWiki News) After a stroke, a person’s physical reflexes and other abilities can change. Those changes may affect how well that person can do regular activities like driving a vehicle.

A recent study found that when stroke survivors got back behind the wheel, some did so without first having their road skills evaluated.

"Ask your doctor about driving safety after a stroke."

Shelly Ozark, MD, a neurologist at Medical University of South Carolina in Charleston, was this study’s lead author. Her team of researchers analyzed how 162 stroke survivors decided whether or not to begin driving again within a year after having their strokes.

As a part of their analysis, these researchers asked the stroke survivors to rate the impact of stroke on their lives by describing it as having “no effect,” “some effect” or “great effect.”

More than half of the participants — 83 of the 162 persons — had begun driving again. And 49 of the 83 (59 percent) resumed driving within one month after their stroke diagnosis. Nine of the 162 stroke survivors (5.6 percent) underwent formal evaluations of their driving skills.

Of the 83 survivors who returned to driving, nine said their strokes had greatly affected their ability to perform important everyday activities.

Also, more than 45 percent of those who began driving again and reported that their strokes had no effect on their ability to complete everyday activities said they had limited the amount of time they drove.

“The resumption of driving following stroke is usually a decision made without formal evaluation. Stroke survivors, including those who self-impose restrictions on their driving, may benefit from formal evaluation before returning to the driver’s seat,” the researchers wrote.

"The neurologic deficits after a stroke can affect all aspects of a person’s life, including driving," said Dr. Chaouki Khoury, a neurohospitalist at Baylor University Medical Center in Dallas, who serves as director of neurology education and director of headache medicine for Baylor University Medical Center at Dallas and Our Children's House at Baylor.

"Often, in the acute hospital setting at the time of the stroke, physicians, patients and families are focused on managing stroke risk factors and arranging for rehabilitation, without much thought to how life after the stroke will change," Dr. Khoury told dailyRx News. "Driving constitutes a major aspect of our daily life, especially in the South where public transportation is very limited. Therefore, patients, their families, and their outpatient clinic providers need to address a patient’s ability to resume driving after their return home, and there are formal assessments to help make this decision. These assessments are available through the DMV as well as through rehabilitation institute."

Dr. Khoury went on to explain how those assessments work. "When the recovery is complete or near-complete, formal assessment may not be necessary and the patient and their provider could make the decision about resuming driving. When the deficit is too severe that it affects several aspects of a patient’s daily life, again formal assessment may not be required, as the patient, the family and the care provider are usually able to make the judgment that the patient should not resume driving," Dr. Khoury said.

"It is in those instances where recovery is only partial that formal assessment can help: it would make sure that patients who think they cannot drive are not limited from driving unnecessarily if the testing reveals them to be safe to drive, and patients who think they can drive but are unsafe are kept from doing so," he said.

Stroke is the fourth leading cause of death in the United States, and 80 percent of strokes are preventable, according to the National Stroke Association.

Strokes occur when a blood clot or other blockage, such as the build-up of harmful cholesterol in the arteries, stops blood flow to the brain and kills brain cells. The National Stroke Association suggests preventing stroke by quitting smoking, exercising regularly, eating well and limiting alcohol consumption.

This investigation by Dr. Ozark and her team was presented February 13 at the International Stroke Conference 2014, hosted by the American Heart Association in San Diego. The study has not yet been accepted for publication in a medical journal.

Review Date: 
February 13, 2014