Background and aims
Blood pressure fluctuates during driving due to tension, which may be related to the onset of stroke. The characteristics of strokes that occur while driving vehicles were examined.
Methods
Of 11,285 acute stroke cases within 7 days of onset registered in the Saiseikai Stroke Database over a 3-year period from April 2018 to March 2021, 68 occurred while driving. The clinical features of these cases were compared with those of 6,626 cases that occurred during daily activities other than driving.
Results
The strokes consisted of TIA, cerebral infarction, cerebral hemorrhage, and subarachnoid hemorrhage in 2.9%, 35.3%, 50.0%, and 11.8% of patients, respectively, in the driving-onset group, and 4.9%, 61.6%, 25.7%, and 7.7% of patients in the other activity group (p<0.0001). The driving-onset group included more males (76.5 vs 57.2%), was younger (64.9 vs 73.1 years old), and had a lower incidence of previous stroke (11.8 vs 24.3%). There were non-significantly fewer lacunar infarctions among cerebral infarctions, fewer cerebellar hemorrhages, and more brainstem hemorrhages among cerebral hemorrhages, with no differences in clinical outcomes at discharge. Nineteen patients had traffic accidents at onset; compared to the 43 patients who did not have traffic accidents, they had more consciousness disturbance and worse clinical outcomes, and subcortical hemorrhage and cardioembolism were more common.
Conclusions
Rates of cerebral and subarachnoid hemorrhages were higher in cases of stroke while driving. Cardioembolism and subcortical hemorrhage were more common in driving-onset patients with traffic accidents, with poor outcomes.