TO DRIVE OR NOT TO DRIVE - NEUROPSYCHOLOGICAL ASSESSMENT FOR DRIVERS LICENSE AMONG STROKE PATIENTS

Seventy-two stroke patients, 43 with right hemisphere (RHD) and 29 wit h left hemisphere damage (LHD), and 7 coronary infarct controls with n o evidence of cerebral damage, were neuropsychologically tested as par t of an assessment program for driver's license. Mean age in the group was 53 years. Stroke patients were tested on average 4 months post in jury. The groups did not differ on major demographic variables except that RHD patients were more often hemiplegic than LHD patients. The te st battery was factor analyzed into 4 valid principal components: (I) visual perception, (II) spatial attention, (III) visuospatial processi ng, and (IV) language/praxis. The presence of hemianopia (factor I) ex cludes driving. In addition, measures of neglect and reduced speed of mental processing from factor II, III and IV, were found to be the mos t discriminating variables when classifying patients for driving. Even though neglect was more frequently observed among RHD than LHD patien ts, the two hemisphere groups did not differ significantly in number o f patients denied driving, 58% RHD compared to 41% LHD patients. The n eed for comprehensive neuropsychological assessment is underlined.