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A Journal on Physical Medicine and Rehabilitation after Pathological Events
Official Journal of the , , , ,
In association with
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063
RETURN TO DRIVING AFTER TRAUMATIC BRAIN INJURY - Part I
Guest Editors: Bruno Gradenigo, Anna Mazzucchi
Europa Medicophysica 2001 December;37(4):201-8
When and how should people be authorised to drive after severe head injuries?
From the Réseau UEROS Aquitaine - France
Starting to drive again after a head injury poses problems to patients, their families, their medical teams and to society as whole. Insurance companies are also affected. The present paper examines the legal framework of this problem in France, the French literature on the subject and the personal experience. On the basis of information collected, the paper identifies three groups of patients: 1) those suffering motor impairments alone who are perfectly capable of driving an appropriately adapted vehicle. 2) those at risk of epileptic fits who may be granted a 2-year provisional licence that will be extended indefinitely if no attacks occur; 3) those with neuropsychological problems. In such cases there appears to be no correlation between the results of cognitive performance tests and driving ability. And while tests designed to assess frontal lobe functions may be indicative, they are not absolutely predictive. Tests on attention span, short-term memory, dexterity, visuo- spatial capacity, reaction times and functional capacities (especially flexibility, planning and anticipation) are essential. Since driving simulators are rarely used, the on-road driving test remains the assessment “Gold Standard”. The paper concludes that: assessment remains an imprecise art; there remain wide variations in the practices of care teams and Medical Boards; treatment and assessment protocols need to be standardised.