Research Article| Volume 29, ISSUE 4, 104634, April 2020

Clinical Characteristics of Driving-related Stroke Occurring as a Recurrent Stroke


      Background: 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. Methods: 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. Results: 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). Conclusion: 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.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Stroke and Cerebrovascular Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Inamasu J.
        • Nakatsukasa M.
        • Tomiyasu K.
        • et al.
        Stroke while driving: frequency and association with automobile accidents.
        Int J Stroke. 2018; 13: 301-307
      1. American Stroke Association. Driving After Stroke. Accessed on September 19, 2019

      2. Stroke Association (U.K.). Driving after a stroke. Accessed on September 19, 2019

        • Burn J.
        • Dennis M.
        • Bamford J.
        • et al.
        Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project.
        Stroke. 1994; 25: 333-337
        • The Japan Stroke Society
        Japanese Guidelines for the Management of Stroke.
        Kyowa Kikaku, Tokyo2009: 2009
        • The Japan Stroke Society
        Japanese Guidelines for the Management of Stroke.
        Kyowa Kikaku, Tokyo2015: 2015
        • Tüchsen F.
        • Hannerz H.
        • Roepstorff C.
        • et al.
        Stroke among male professional drivers in Denmark, 1994-2003.
        Occup Environ Med. 2006; 63: 456-460
        • Chen J.C.
        • Chen Y.J.
        • Chang W.P.
        • et al.
        Long driving time is associated with haematological markers of increased cardiovascular risk in taxi drivers.
        Occup Environ Med. 2005; 62: 890-894
        • Johnston S.C.
        • Elm J.J.
        • Easton J.D.
        • et al.
        Time course for benefit and risk of clopidogrel and aspirin after acute transient ischemic attack and minor ischemic stroke.
        Circulation. 2019; 140: 658-664
        • Hilkens N.A.
        • Algra A.
        • Kappelle L.J.
        • et al.
        Early time course of major bleeding on antiplatelet therapy after TIA or ischemic stroke.
        Neurology. 2018; 90: e683-e689
        • Inamasu J.
        • Miyatake S.
        • Yagi T.
        • et al.
        Acute coronary syndromes occurring while driving: frequency and patient characteristics.
        Environ Health Prev Med. 2017; 22: 82
        • Nielsen V.G.
        • Hafner D.T.
        • Steinbrenner E.B.
        Tobacco smoke-induced hypercoagulation in human plasma: role of carbon monoxide.
        Blood Coagul Fibrinolysis. 2013; 24: 405-410
        • Mohan K.M.
        • Wolfe C.D.
        • Rudd A.G.
        • et al.
        Risk and cumulative risk of stroke recurrence: a systematic review and meta-analysis.
        Stroke. 2011; 42: 1489-1494