Neuropsychological Assessment in Traumatic Brain Injury

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Role of neuropsychology in TBI

TBI is not only the most common brain injury/disease but also one of the more heterogeneous. TBI can result in graded neurological, physical, emotional, and neuropsychological changes and deficits that are dependent on the injury severity; however, it should be emphasized that the Glasgow Coma Scale (GCS) score itself does not necessarily predict the degree of injury or consequent dysfunction. Preexisting psychological and psychosocial factors, as well as several post-incident factors and

Process of neuropsychological assessment

The neuropsychological evaluation in the TBI patient requires a comprehensive approach to assess most cognitive domains, psychiatric symptoms, psychological factors, and psychosocial variables and functioning. The evaluation must assess both acute and chronic deficits to best predict functional outcome and ability.7 The evaluation is key in working through the differential diagnosis of post-TBI presentation and provides the basis for constructing the therapeutic strategy.43 Neuropsychological

Neuropsychological domains

The formal neuropsychological assessment in TBI assesses a wide variety of areas including estimates of pre-injury abilities, test engagement, formal neuropsychological domains, psychiatric status, and emotional functioning (Box 2).

Executive functions in TBI

The executive functions and its substrate the frontal lobes are affected in a variety of clinical conditions and are vulnerable in TBI,68, 69 either in the presence of a focal lesion or not. Frontal lobe dysfunctions in TBI can be secondary to direct frontal injury or injury disrupting the reticular-frontal connection. In addition to the frontal lobes, other neuroanatomic structures can have a role in the executive control: These structures include the anterior cingulate cortex, basal ganglia,

Neuropsychological deficits associated with TBI

TBI is associated with a wide range of physiological, behavioral, emotional, and cognitive sequelae. The extent and degree of sequelae varies depending on the severity and location of the injury mitigated by premorbid and post-injury factors and support.

Summary

TBI is a neurological injury that may affect the cognitive, emotional, psychological, and physical functioning of an individual. The clinical neuropsychologist working with TBI patients must take a holistic approach and consider the patient in total, including premorbid and post-incident factors, when assessing and treating the patient in order to formulate a comprehensive and accurate picture of the patient that will be used to build an accurate diagnostic impression and guide multiple types

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