Department of Neurosurgery, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Department of Neurology, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
J Stroke Cerebrovasc Dis. 2020 Apr;29(4):104634. doi: 10.1016/j.jstrokecerebrovasdis.2019.104634. Epub 2020 Jan 18.
Although the number of seemingly healthy subjects who suffer a minor stroke increases, there are no data on how frequently they sustain another stroke while driving.
A single-center, retrospective study was conducted to clarify the clinical characteristics of driving-related stroke occurring as a recurrent stroke by analyzing data prospectively acquired between January 2009 and June 2019 on 3452 acute stroke patients.
One hundred-thirty five patients (85 ischemic stroke [IS] and 50 hemorrhagic stroke [HS]) had suffered a driving-related stroke. Of them, 22 (16%) had suffered a prior stroke (recurrent stroke group), while 113 had never suffered a stroke before (first-time stroke group). While the use of anti-thrombotics was significantly more common in the RS group, other variables including the frequency of road traffic accidents, did not differ significantly. The first stroke-recurrent stroke interval ranged from 0.2 to 18 years. The stroke type at the time of recurrence was IS in the majority of patients with prior IS. When compared to 432 patients with recurrent IS unrelated to driving, patients with recurrent IS related to driving (n = 16) had significantly higher frequency of lacunar strokes (56% vs 27%, P = .02) and lower frequency of cardioembolic strokes (6% vs 29%, P = .04).
The current finding that 16% of patients who presented with driving-related stroke had previously suffered a stroke indicates that drivers with a prior stroke may be at increased risk for recurrent stroke while driving, and prolonged follow-up be necessary for minor stroke patients who resume driving.
尽管越来越多看似健康的患者发生小卒中,但有关他们在驾驶时再次发生卒中的频率的数据仍较少。
本单中心、回顾性研究通过分析 2009 年 1 月至 2019 年 6 月期间前瞻性采集的 3452 例急性卒中患者的数据,旨在阐明作为复发性卒中发生的与驾驶相关卒中的临床特征。
135 例患者(85 例缺血性卒中和 50 例出血性卒中)发生了与驾驶相关的卒中。其中 22 例(16%)曾发生过卒中(复发性卒中组),113 例患者之前从未发生过卒中(首次卒中组)。RS 组抗血栓药物的使用明显更常见,其他变量(包括道路交通事故频率)差异无统计学意义。首次卒中-复发性卒中的间隔时间为 0.2 至 18 年。复发性卒中的类型在既往发生过 IS 的患者中多数为 IS。与 432 例与驾驶无关的复发性 IS 患者相比,与驾驶相关的复发性 IS 患者(n=16)腔隙性卒中的频率明显更高(56% vs. 27%,P=0.02),心源性栓塞性卒中的频率更低(6% vs. 29%,P=0.04)。
当前的研究发现,16%发生与驾驶相关的卒中的患者曾发生过卒中,表明有既往卒中史的驾驶员在驾驶时再次发生卒中的风险可能增加,对于恢复驾驶的小卒中患者需要进行延长随访。