[Certain issues concerning medical certification and driving fitness assessment after craniocerebral traumas].

Background: The incidence of craniocerebral traumas increases with a growing number of road accidents. It should be emphasized that it is rather difficult to determine precisely the craniocerebral traumas incidence rate, however, it is well known that road accidents are the major cause of these injuries.

Material And Methods: The study embraced 43 men (mean age: 47.1; SD: 11.4) after craniocerebral traumas. Of the 43 men, 23 drivers had driving license of the following classes: A, Al, A2, AM, B, B1 and BE without professional driving permit, and 20 men worked as professional drivers licensed according to the following classes: C, CE, C1, C1E, D, DE, D1 and DIE. The duration of drivers' employment ranged from 4 to 33 years (mean: 19 years; SD: 7.7). The clinical diagnosis was based on the patient's medical history, medical records, neurological examination complemented with other specialist examinations.

Results: Posttraumatic encephalopathy diagnosed in 23 (53.5%) patients was characterized by varied clinical symptoms. Posttraumatic simple encephalopathy diagnosed in 13 patients was the most frequent contradiction to run motor vehicles. Posttraumatic epilepsy was a contradiction in 5 and posttraumatic subarachnoid haemorrhage in 2 patients (one with neurological deficiency hemiparesis, the other with frontal lobe syndrome. Following the treatment 46.5% of men under study did not show neurological deficits and were allowed to run motor vehicles.

Conclusions: The certification procedure in cases of past craniocerebral traumas should not follow the routine and careful examination of each individual case is required prior to assessing a driver's ability to run motor vehicles.