Objectives The aim of this study was to examine the effect of traumatic brain injury (TBI) on drivers' ability to anticipate traffic hazards. Slower anticipation of hazards has been associated with higher crash rates, but this driving skill has never been assessed after TBI.

Methods The anticipatory ability of 31 drivers with TBI and 24 age-matched uninjured controls was assessed with a validated drivers' Hazard Perception Test. The Hazard Perception Test displayed videos of genuine traffic scenes filmed from the driver's perspective, and participants had to respond as soon as they anticipated a traffic hazard in a scene. The primary dependent measure was mean response latency.

Results Participants with TBI were significantly slower to anticipate traffic hazards than controls (p<0.001). Within the TBI group, while hazard perception response times were significantly related to duration of post-traumatic amnesia (Spearman ρ=0.63; p<0.001), they were not significantly related to Glasgow Coma Scale scores (r=−0.19; p=0.33). Also, participants with a complicated mild TBI were significantly faster in anticipating traffic conflicts than participants with moderate to severe TBI (p=0.04).

Conclusions Individuals with TBI were slower to anticipate traffic hazards than age-matched uninjured controls. This finding signifies the need for hazard perception testing and training as part of driving rehabilitation after TBI.