Abstract W MP54: Increased Collisions and Errors at Intersections During Simulated Driving in Patients after Aneurysmal Subarachnoid Hemorrhage

• Published in: Stroke (1970) 2015-02, Vol.46 (suppl_1)
• Main Authors: Vesely, Kristin A, Hird, Megan A, Manoel, Airton Leonardo de Oliveira, Macdonald, R. Loch, Schweizer, Tom A
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.46.suppl_1.wmp54

Abstract only Introduction: It is well established that cognitive and functional impairments persist despite good clinical outcomes in patients who suffer aneurysmal subarachnoid hemorrhage (aSAH). The impact of these impairments on real-world tasks such as driving a motor vehicle is currently unclear. This study aimed to investigate driving ability of aSAH patients using a driving simulator. We hypothesized that patients would exhibit more driving errors during the most cognitively demanding aspects, particularly while executing left turns at busy intersections, where the driver must quickly integrate many complex and dynamic visual stimuli to make a rapid decision and turn safely. Methods: Nine functionally independent aSAH patients (>3 months post-ictus) and nine healthy control participants matched for age (patients: 58±13; controls: 59±14, p > 0.05) completed two driving scenarios (STISIM). The total number of errors committed and errors associated with intersections were compared between groups. Errors included collisions, speeding, centerline crossings, road edge excursions, stop signs missed and traffic light tickets. Results: The mean number of total errors did not differ between the patient and control groups (28 versus 22, p > 0.05); however, patients committed a greater number of hazardous errors, including collisions (2.4 versus 0.1, p < 0.05) and road edge excursions (3.7 versus 0.3, p < 0.01), than controls. Total errors at intersection turns were greater for patients (7.7 versus 3.2, p < 0.05). When stratified by type of turn, patients experienced more errors than controls during left turns (1.6 versus 0.2, p < 0.01) and left turns with oncoming traffic (2.3 versus 0.8, p < 0.05) but not during right turns (3.8 versus 2.2, p > 0.05). Conclusion: Our results suggest probable driving impairment in some aSAH patients during more difficult aspects of driving, such as making left turns at a busy intersection, which is where most real-world accidents occur. This analysis was limited by a small sample, and further research should explore the clinical and cognitive correlates of driving ability in a large sample of aSAH patients.