[Physicians' control of driving after stroke attacks].

BACKGROUND

The Finnmark Stroke Register is an investigation of new cases of stroke in a Norwegian county between April 1998 and March 2002; 622 were first attacks. The aim of this study was to estimate how physicians deal with driving issues in these patients in the sub-acute stage and during the first year after the stroke.

MATERIAL AND METHODS

Evaluations of fitness to drive were made by the author and research nurses in the sub-acute stage and through telephone interviews after three and twelve months.

RESULTS

45% of first attack survivors had a valid driving licence. Usually the medical records contained no information concerning the license; this information was obtained during the follow up. 80% of patients with a licence did not fulfill the requirements for driving in the sub-acute stage because of neurological, cognitive or ophthalmologic impairment. Less than half of these patients were told not to drive. Many of the others went on driving. One year later, about 40% of patients with a valid license did not fulfill the requirements for driving. Several cases of homonymous hemianopia escaped detection for a long time.

INTERPRETATION

Physicians should note the possession of a driving licence in the medical records. If indicated, acute stroke patients should receive temporary verbal and written information not to drive. Special concern ought to be given to visual disturbances. Uniform standards concerning fitness to drive ought to be developed in Norway.