van Zomeren A H, Brouwer W H, Minderhoud J M
Department of Neuropsychology, University Hospital, Groningen, The Netherlands.
Arch Phys Med Rehabil. 1987 Oct;68(10):697-705.
Five issues in evaluating driving ability after brain damage were addressed through a review of the literature. Some preliminary conclusions were reached: (1) about half of all subjects studied still hold a valid driver's license; (2) brain-damaged drivers could not, in general, be seen as risky drivers, although some individuals show decreased driving skill and risky behavior in traffic; and (3) statistics show no increase in traffic violations or accidents in groups of neurologic patients with acquired brain lesions or diseases. Frequently noted problems of brain-damaged drivers include poor judgment of traffic situations, impulsivity, and visuospatial impairments. Traditional psychologic tests have insufficient predictive value regarding fitness to drive. It is suggested that new techniques be developed to enable more valid statements about the skills needed for safe traffic participation. These assessment techniques should emphasize the higher cognitive levels in driving, ie, the tactical and strategic levels. At the moment, driver training programs in rehabilitation focus mainly on the operational level, with emphasis on handling the car, use of controls and mirrors, and technical adaptation of the vehicle.
通过文献综述探讨了脑损伤后驾驶能力评估中的五个问题。得出了一些初步结论：（1）所有研究对象中约有一半仍持有有效驾照；（2）一般而言，脑损伤驾驶员不能被视为危险驾驶员，尽管一些个体在交通中表现出驾驶技能下降和危险行为；（3）统计数据显示，患有后天性脑损伤或疾病的神经科患者群体中，交通违规或事故并未增加。脑损伤驾驶员经常出现的问题包括对交通情况判断不佳、冲动以及视觉空间障碍。传统心理测试对于驾驶适宜性的预测价值不足。建议开发新技术，以便就安全参与交通所需技能做出更有效的陈述。这些评估技术应强调驾驶中的较高认知水平，即战术和战略层面。目前，康复中的驾驶员培训项目主要侧重于操作层面，重点是操控汽车、使用控制装置和后视镜以及对车辆进行技术调整。
