Traumatic Brain Injury

What is a traumatic brain injury (TBI)?

Traumatic brain injury (TBI) occurs when a sudden trauma causes damage to the brain. It can result from an object hitting the head or piercing through the skull, or from the head undergoing a rapid acceleration/deceleration of forces. It can lead to changes in cognitive, physical, and psychosocial functions, with an associated diminished or altered state of consciousness. There is a significant range in severity of a TBI which depend on key factors including duration of loss of consciousness (LOC), post-traumatic amnesia (PTA; confusion or inability to remember events), and Glasgow Coma Scale (GCS) rating.

The most common type of injury is a mild TBI, which is sometimes called a concussion. In a mild TBI or concussion, people may report not remembering what happened immediately before or after the injury. They can act more confused as well. Additional complaints may include memory, judgment, reflexes, speech, balance, and muscle coordination.

Postconcussive Syndrome

Although most symptoms of concussion are in remission within the first couple of days following the event, some people who suffer a head injury report side effects that persist for weeks or months. This is known as postconcussive syndrome. Symptoms include memory and concentration problems, mood swings, personality changes, headache, fatigue, dizziness, insomnia and excessive drowsiness.

What is the role of a neuropsychological evaluation?

After a brain injury, a neuropsychological evaluation is critical for understanding which brain functions may have been impacted and how to assist in regaining pre-injury functioning. The evaluation would include an interview with the client and/or collaterals, review of medical history, neuroimaging, and testing.

The neuropsychological evaluation may be essential to determine if there are long-lasting effects after a brain injury. This is especially true following “mild” brain injury, when effects of an injury may be subtle and easily confused with other factors, such as stress, medications, or depression. The evaluation can determine if there was an injury, if there is impairment from it, what the cause of impairment is, and what emotional or psychological factors are influencing performance or daily functioning. The results of the evaluation can be very helpful in rehabilitation or in providing treatment recommendations for work, school, and other aspects of daily living as well.