Health and Psychology

Brain injuries occur from a variety of causes.  The most common type of brain injury is a closed head injury.  About 300,000 individuals with closed head injury seek medical care from emergency rooms each year.  Many more individuals with closed head inury actually think they are fine following the injury and it's not until days, weeks or months later that they notice symptoms.  Often they have no idea that their symptoms are caused by a closed head injury and they seek medical care for symptom relief.

Common symptoms of brain injury include dizziness, nausea, headache or confusion at the time of the injury and bruises that seem significant from impact or from being restrained by seatbelts.  Difficulties with speech and language, memory problems, changes in personality, and problems getting back into routine are common symptoms of brain injury which may not be appreciated during the initial days following the injury.

Neuropsychological evaluation of brain injury involves taking a thorough history of how the person functioned prior to the injury.  Information on education, family life, work history, and social functioning help to establish a baseline of how the individual was doing prior to the injury.  A thorough evaluation of the actual injury including a review of any medical information, accident reports, witness statements, and an understanding of the physics and body mechanics involved in brain injury help to tie together the accident or injury with the difficulties the person is experiencing.

Neuropsychological testing shows objective evidence of cortical functioning of the brain.  in many cases, when imaging studies appear to have normal results, the neuropsychological test results can document clear deficits from prior levels of functioning.  Neuropsychological testing is a complex evaluation which can take place over several days and involve multiple hours of assessment.  The environment may be structured to document impact of flourescent lighting versus incandescent lighting, time of day impacts, and the impact of food and hunger states on the test results.  It's important for a neuropsychologist to be aware of the order, sequence, and selection of test materials to clearly demonstrate functional abilities and to document changes in functioning from expected levels.

I specialize in complex neuropsychological evaluations to document changes as a result of injury, accident, toxic exposure, or medical condition.