Neuropsychologists frequently conduct neuropsychological evaluations to determine the neurobehavioural status of persons following minor injuries to the head with mild traumatic brain injury. Typically these persons experience some type of injury to the head with either brief or no loss of consciousness. They report changes in physical and mental functioning adversely affecting their normal adaptation. The neuropsychologist is asked to evaluate these patients and address several questions: Is there evidence of neurobehavioral dysfunction? If so, what are the causes of the dysfunction? What are the practical effects of impairments upon real-world functioning? What treatments and rehabilitation are indicated?
Well trained clinical neuropsychologists knowledgeable in the relevant research and clinically experienced with mild traumatic brain injury are uniquely qualified to tackle these questions, and play a key role in diagnosis and management. The neuropsychologist’s knowledge of brain functions, neurobehavioral problems associated with neurologic and psychiatric disorders, mild traumatic brain injury, as well as neuropsychological assessment methods provide special contributions. A major strength is neuropsychological testing. Neuropsychological tests allow a quantification of brain functioning not found in other clinical disciplines. The work of the neuropsychologist often leads to a quantified understanding of the person and provides direction for treatments.
This role is however fraught with pitfalls potentially leading to misdiagnosis, misunderstanding of the person, and mismanagement. A number of challenges confront the neuropsychologist working with patients having mild traumatic brain injury. Those challenges include: A limited knowledge base, misconceptions, biases, overlapping disorders, overlapping symptoms, limited technology, and motivation. This article discusses these challenges and suggests ways to avoid these diagnostic pitfalls.
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