軽症くも膜下出血患者に対する自動車運転能力評価の必要性─アンケート調査と経時的な神経心理学的検査より

The necessity of driving ability assessment for patients with mild subarachnoid hemorrhage : Using questionnaires and sequential neuropsychological examinations

要旨：身体機能障害を残さない軽症くも膜下出血（subarachnoid hemorrhage；以下，SAH）患者は，早期に運転再開を希望する場合が多く，退院までに運転能力を評価することは重要である．研究1ではSAH患者45名を対象にアンケート調査を行い，自動車運転再開の実態と課題を明らかにした．結果，運転を再開した事例の中には高次脳機能障害を疑う症状を有する者がいることが分かった．研究2ではSAH患者6名を対象に，3種類の神経心理学的検査の経時的評価を行った．従来の神経心理学的検査のみでは，軽症SAH患者の運転可否の予測は困難である可能性が示された．今後，カットオフ値の再検討と予測精度の高い評価法の開発が必要と考えられた．

　Patients with subarachnoid hemorrhage (SAH）with only mild physical functional disorders often hope for early driving resumption, and it is important for occupational therapists to evaluate driving ability at discharge. The purpose of this study was to clarify actual situations and problems of driving resumption after SAH onset. In research 1, a questionnaire was administered to 45 patients with SAH. The results showed that some patients who had resumed driving exhibited cognitive brain functional disorders and anxiety. In research 2, three neuropsychological examinations were performed on 6 patients with SAH. Using cutoff values of conventional neuropsychological examinations, the driving ability of mild SAH patients could not be accurately predicted. These results suggest the necessity to reexamine cutoff values for driving and to develop highly predictable examination methods.