First of all, we would like to commend the authors of “Assessment of Driving Restrictions Following Craniotomy: A Survey of Canadian Neurosurgeons”^{Reference Ndongo Sonfack1} on their efforts in publishing this manuscript. This study addresses a clinically relevant issue with implications for the daily life of craniotomy patients and reflects one of the premier questions after surgery. Driving is closely related to patient autonomy, social interactions and even employment, and can have consequences to the patient extending beyond the immediate postoperative recovery. Few studies have briefly discussed the dilemmas surrounding driving among brain tumor patients, and even after a Delphi consensus study, clear guidelines have yet to be finalized.^{Reference Lapidus, Devitt and Herbison2,Reference Mansur, Hird, Desimone, Pshonyak, Schweizer and Das3} Authors have initiated discussions around driving in postsurgical patients, and this paper should contribute to these discussions.

A systematic review of 1085 patients showed that 12.3% of patients developed new seizures after elective resections of supratentorial meningiomas.^{Reference Englot, Magill, Han, Chang, Berger and McDermott4} A large retrospective study also found new-onset seizures in 4.6% of a mixed population of meningiomas and gliomas.^{Reference Oushy, Sillau and Ney5} Together, these findings indicate that the risk of a patient developing a seizure after surgery is not negligible. As noted in the current study, a wide variety of differences in practice exist concerning driving restrictions following resections of different types of tumors. These differences often stem from individual tumor characteristics, such as the presence of peritumoral edema or tumor location that makes patients more susceptible to postoperative seizures.^{Reference Oushy, Sillau and Ney5} In this context, the United Kingdom has adopted a more comprehensive, albeit stricter, approach to post-craniotomy driving restrictions. Current UK guidelines differentiate between grade 1–3 meningiomas with driving restrictions ranging from 6 to 24 months and gliomas with restrictions from 1 to 2 years.

Ideally, future guidelines should be comprehensive but pragmatic, finding a middle ground between individual patient factors and a histology-based approach. Methodologically, the authors have taken the correct approach in starting with a systematic review and following it up with a survey.^{Reference Ndongo Sonfack1,Reference Bergeron, Ndongo Sonfack and Moshref6} The next step would be an expert consensus development in collaboration with the regulatory bodies, followed by the distribution of this new information on an accessible platform to support evidence-based counseling across Canada.