Table of Contents
Preface
Acknowledgments
About the Author
Chapter 1
AN OVERVIEW OF MILD TO MODERATE CLOSED-HEAD INJURY
§ 1-1. Understanding the Condition
§ 1-1(a). Defining Closed-Head Injury
§ 1-1(b). Types of Brain Injury
§ 1-1(c). Incidence and Prevalence
§ 1-1(d). Costs and Economic Impact
§ 1-2. Postconcussion Syndrome (PCS)
§ 1-3. Recovery and Outcome
§ 1-3(a). Assessment of Progress
§ 1-3(a)(1). Glasgow Coma Scale
§ 1-3(a)(2). Rancho Los Amigos Levels of Cognitive Recovery
§ 1-3(b). Predictors of Recovery
§ 1-3(c). Outcome Measurement
§ 1-3(c)(1). Glasgow Outcome Scale
§ 1-3(c)(2). Disability Rating Scale
§ 1-3(c)(3). Functional Independence Measure
§ 1-3(d). Effects on Life Expectancy
References
Chapter 2
WHO GOES WHERE FOLLOWING THE INJURY: PATHS TO PSYCHOLOGICAL EVALUATION
§ 2-1. Who Goes to the Hospital?
§ 2-2. Who Goes Home from the Emergency Room?
§ 2-3. Who May Not Go to the Emergency Room?
§ 2-4. Mild TBI and Psychological Assessment
§ 2-5. Epidemiology and Psychological Assessment
§ 2-6. The Patient Consults the Psychologist: The Patient's Complaints and Expectations
§ 2-7. Searching for Signs
§ 2-8. And a Detour
§ 2-9. Acceleration, Deceleration, And Related Injuries
References
Chapter 3
DIAGNOSING CLOSED-HEAD INJURY: CLINICAL EXAMINATION AND SEQUELAE OF MILD TO MODERATE CLOSED-HEAD INJURY
§ 3-1. The Neurologic Examination
§ 3-1(a). Mental Status Examination
§ 3-1(b). Cranial Nerve Examination
§ 3-1(c). Motor Examination
§ 3-1(c)(1). Evaluation of Gait
§ 3-1(c)(2). Cerebellar Examination
§ 3-1(c)(3). Extrapyramidal Evaluation
§ 3-1(d). Sensory Examination
§ 3-1(e). Reflex Examination
§ 3-1(f). Cerebellar Examination
§ 3-1(g). Speech Examination
§ 3-1(h). General Examination
§ 3-1(i). Topographical Brain Mapping
§ 3-1(j) Computerized Tomography Scanning (CT)
§ 3-1(k) Magnetic Resonance Imaging (MRI)
§ 3-2. Sequelae of Mild to Moderate Closed-Head Injury
§ 3-2(a). Postconcussion Syndrome (PCS)
§ 3-2(a)(1). Incidence
§ 3-2(a)(2). Historical Perspective
§ 3-2(a)(3). Organic Evidence
§ 3-2(a)(4). Classification
§ 3-2(a)(5). Treatment
§ 3-2(a)(6). Prognosis
§ 3-2(b). Physical and Motor Sequelae
§ 3-2(c). Cognitive and Perceptual Sequelae
§ 3-2(c)(1). Posttraumatic Amnesia (PTA)
§ 3-2(d). Social and Behavioral Sequelae
§ 3-2(e). Anosognosia
§ 3-2(f). Other Complications
§ 3-2(f)(1). Myofascial Pain and Fibromyalgia
§ 3-2(f)(2). Temporomandibular Joint Pain
§ 3-2(f)(3). Neck and Back Injuries Associated with Head Injuries
§ 3-2(f)(4). Posttraumatic Headache
References
Chapter 4
STRUCTURES AND FUNCTIONS OF THE BRAIN REVISITED
§ 4-1. Introduction
§ 4-1(a). Transitions
§ 4-2. Computerized Tomography
§ 4-2(a). Clinical and Cost Advantages of CT Scans
§ 4-2(b). CT Scan Limitations
§ 4-3. Some Orienting Thoughts about Neuroimaging
§ 4-3(a). Pixels and Voxels
§ 4-3(b). Where does One Take the Picture?
§ 4-3(c). Images as Hypotheses
§ 4-3(d). Ways Images Can Blur
§ 4-4. Structural Magnetic Resonance Imaging
§ 4-4(a). Structural MRI Advantages
§ 4-4(b). MRI Limits
§ 4-4(c). Variants of Structural MRIs
§ 4-4(c)(1). FLAIR MRIs
§ 4-4(c)(2). Diffusion MRIs
§ 4-4(c)(3). Functional MRIs
§ 4-4(c)(3)(a). Functional MRI Limitations
§ 4-5. Positron Emission Tomography
§ 4-6. The Brain in Action
§ 4-6(a). PET Scan Advantages
§ 4-6(b). PET Scan Disadvantages Include
§ 4-7. Single Photon Emission Computed Tomography (SPECT) Scanning
§ 4-7(a). SPECT Scans in Action
§ 4-7(b). SPECT Scan Advantages and Limitations
§ 4-7(c) MRI Diffusion Tensor Imaging (DTI)
§ 4-8. Conclusion
References
Chapter 5
SEARCHING FOR SIGNS: A POSSIBLE FLEXIBLE APPROACH TO PSYCHOLOGICAL AND NEUROPSYCHOLOGICAL ASSESSMENT
§ 5-1. Introduction
§ 5-2. Attention and Concentration
§ 5-3. Vigilance
§ 5-4. Retention and Recall
§ 5-5. Digit Span (DS)
§ 5-6. Digits Forward (DSF)
§ 5-7. Digits Backward (DSB)
§ 5-8. Spatial Span
§ 5-9. Letter Number Sequences
§ 5-10. Summary
§ 5-11. And a Reliable Detour
References
Chapter 6
COMPLICATIONS AND UNUSUAL CLINICAL PRESENTATIONS
§ 6-1. Complications
§ 6-1(a). Cerebral Edema
§ 6-1(b). Visual Disturbances
§ 6-1(c). Herniation
§ 6-1(d). Hematoma
§ 6-1(d)(1). Arteriovenous Malformations
§ 6-1(e). Intracranial Thrombosis
§ 6-1(f). Disruption of the Blood Brain Barrier
§ 6-1(g). Cranial Nerve Injury
§ 6-1(g)(1). Impairment of Smell
§ 6-1(g)(1)(a). Injury to Olfactory Nerve Fibers
§ 6-1(g)(1)(b). Mechanical Injuries to Nose and Nasal Passages
§ 6-1(g)(1)(c). Injury to Brain
§ 6-1(h). Rhinorrhea and Otorrhea
§ 6-1(i). Vomiting
§ 6-1(j). Cardiovascular
§ 6-1(k). Respiratory
§ 6-1(l). Hemostatic
§ 6-1(m). Water and Electrolyte
§ 6-1(n) Vestibular Dysfunction
§ 6-2. Unusual Clinical Presentations
§ 6-2(a). Movement Disorders
§ 6-2(a)(1). Parkinsonism and Tremors
§ 6-2(a)(2). Tics and Tourette's Syndrome
§ 6-2(a)(3). Dystonia
§ 6-2(a)(4). Chorea, Choreoathetosis, Ballismus
§ 6-2(b). Seizure Disorders
§ 6-2(b)(1). Epilepsy or Seizure Disorder of Unknown Origin
§ 6-2(b)(1)(a). Classification of Seizure Types
§ 6-2(b)(1)(b). Incidence
§ 6-2(b)(1)(c). Onset
§ 6-2(b)(1)(d). Prognosis
§ 6-2(b)(1)(e). Epileptogenesis
§ 6-2(b)(1)(f). Electroencephalographic Changes
§ 6-2(b)(1)(g). Prevention and Prophylaxis
§ 6-2(b)(2). Multiple, Partial, Seizure-like Symptoms
§ 6-2(c) Malingering: Somatoform Disorder
§ 6-2(c) (1) Somativation Disorder
§ 6-2(c) (2) Conversion Disorder
§ 6-2(c) (3) Hypochondriasis
§ 6-3. Other Rare Abnormalities
§ 6-3(a). Avellis Syndrome
§ 6-3(b). Collet-Sicard Syndrome
§ 6-3(c). Sundown Syndrome
§ 6-3(d). Swallowing Difficulties
§ 6-3(e). L'Hermitte Sign
§ 6-3(f). Sleep Disorders
§ 6-3(f) (1) Narcolepsy
§ 6-3(f) (2) Sleep-Wake Disturbances
§ 6-3(g). Amenorrhea and Impotence
§ 6-3(h). Transient Global Amnesia
§ 6-3(i). Diencephalic Seizures
References
Chapter 7
NEUROPATHOLOGY
§ 7-1. Introduction
§ 7-2. Animal Models
§ 7-3. Anatomy of the Brain
§ 7-3(a). Neurons
§ 7-3(a)(1). Diaschisis
§ 7-3(a)(2). Neurotransmitters
§ 7-4. The Physics of Brain Movement
§ 7-4(a). Forces Causing Brain Damage
§ 7-5. Primary and Secondary Injury
§ 7-5(a). Brainstem Injury
§ 7-5(b). Primary Brain Injury
§ 7-5(b)(1). Diffuse Axonal Injury (DAI)
§ 7-5(b)(2). Brain Morphology Changes
§ 7-5(b)(3). Concussion
§ 7-5(c). Secondary Injury
§ 7-5(c)(1). Hemorrhage
§ 7-5(c)(2). Edema
§ 7-5(c)(3). Brain Shift and Herniation
§ 7-5(c)(4). Loss of Autonomic Self-Regulation
§ 7-5(c)(5). Hypoxia and Ischemia
§ 7-5(c)(6). Posttraumatic Epilepsy
§ 7-6. Damage at the Cellular Level
§ 7-6(a). Cytoskeletal Injury
§ 7-6(b). Neurotransmitter Changes
§ 7-6(b)(1). Acetylcholine
§ 7-6(b)(2). Excitatory Amino Acids
§ 7-6(b)(3). Increased Catecholamines
§ 7-6(c). Metabolic Changes
§ 7-7. Summary
References
Chapter 8
CHILD HEAD INJURY
§ 8-1. Introduction
§ 8-2. Incidence
§ 8-3. Causes of Child Head Injury
§ 8-3(a). Vehicular Accidents
§ 8-3(b). Child Abuse
§ 8-3(c). Assault
§ 8-3(d). Sports
§ 8-4. Pathophysiology of Head Injury in Children
§ 8-5. Diagnosis
§ 8-5(a). Amnesia
§ 8-5(b). Neurodiagnostic Tests
§ 8-5(b)(1). Environment
§ 8-5(b)(2). CT Scanning for Acute Trauma
§ 8-5(b)(3). MRI
§ 8-5(b)(4). Ultrasound
§ 8-5(b)(5). SPECT Imaging
§ 8-5(b)(6). PET
§ 8-5(b)(7). EEG Findings
§ 8-5(c). Educational Testing
§ 8-5(d). Neuropsychological Testing
§ 8-5(e). Behavioral Assessment
§ 8-5 (f) Shaken Impact Baby Syndrome (SIBS)
§ 8-5 (f)(1) Neurodiagnostic Evaluations
§ 8-6. Cognitive Sequelae in Children
§ 8-6(a). Intellectual-Academic Disorders
§ 8-6(b). Psychomotor Disorders
§ 8-6(c). Social-Affective Disorders
§ 8-7. Complications in Children
§ 8-7(a). Transient Cortical Blindness
§ 8-7(b). Reduced Auditory Acuity
§ 8-7(c). Persistent Headaches
§ 8-7(d). Postconcussion Syndrome
§ 8-7(e). Posttraumatic Seizures
§ 8-7(f). Transient Global Amnesia
§ 8-8. Outcome Predictors
§ 8-9. Rehabilitation Issues
§ 8-9(a). Return to School
References
Chapter 9
DEVELOPMENTAL PSYCHOLOGY
§ 9-1. Introduction
§ 9-2. Developmental Lines
§ 9-2(a). Prenatal Central Nervous System Developmental Events
§ 9-2(b). Some Postnatal Aspects of Brain Development
§ 9-3. Luria's View of the Developing Brain
§ 9-3(a). Functional Unit I
§ 9-3(b). Functional Unit II
§ 9-3(c). Functional Unit III
§ 9-4. Developmental Lines: Piaget's Views of Developing Abilities to Think
§ 9-4(a). Stage I: The Sensory Motor Stage
§ 9-4(b). Stage II: The Preoperational Stage or the Symbolic Stage
§ 9-4(c). Stage III: The Concrete Operational Stage
§ 9-4(d). Stage IV: The Formal Operational Stage
§ 9-5. Developmental Lines and Trauma
§ 9-6. Incidence of childhood Traumatic Brain Injury
§ 9-7. Causes for Head Injury in Children and Adolescents
§ 9-7(a). Neonatal Injuries
§ 9-7(b). Child Abuse
§ 9-7(c). Falls
§ 9-7(d). Bicycle-Related Injuries
§ 9-7(e). Sports-Related Injuries
§ 9-7(f). Car Crashes
§ 9-8. Pathophysiology
§ 9-8(a). Timing of Childhood Head Injuries in the Developmental Line
§ 9-8(b). Pathophysiology Associated with Acceleration, Deceleration, Torque,
and Contrecoup
§ 9-9. Early and Continuing Aspects of TBI Diagnosis
§ 9-9(a). Early Behavioral Assessment of Cortical Tone and Memory
§ 9-10. Neuroimaging
§ 9-10(a). CT Scanning
§ 9-10(b). Magnetic Resonance Imaging
§ 9-10(c). Functional MRIs
§ 9-10(d). PET (Positron Emission Tomography) Scans
§ 9-10(e). SPECT (Single Photon Emission Computed Tomography Scans
§ 9-10(f). EEG
§ 9-11. Developmental Tasks
§ 9-11(a). Things Developmental Lines Can Teach Us
§ 9-11(b). Psychological Assessment of TBI Sequelae in Children
§ 9-11(c). Decisions to Return to School
§ 9-11(d). Mild TBI
§ 9-12. Psychological Assessment Tools for Children
References
Chapter 10
PSYCHIATRIC COMPLICATIONS
§ 10-1. Introduction
§ 10-2. History
§ 10-3. Incidence of Psychiatric Complications
§ 10-4. Diagnostic and Statistical Manual, Mental Disorders, (DSM-IV)
§ 10-5. Brain Region Correlations
§ 10-6. Immediate Direct Organic Brain Injury
§ 10-6(a). Coma
§ 10-6(b). Concussion
§ 10-6(c). Delirium
§ 10-6(d). Posttraumatic Amnesia (PTA)
§ 10-7. Cognitive Impairment
§ 10-7(a). Intelligence
§ 10-7(b). Memory
§ 10-8. Postconcussion Syndrome
§ 10-8(a). Role of Postconcussion Syndrome in Recovery
§ 10-9. Posttraumatic Stress Syndrome
§ 10-10. Personality Changes
§ 10-10(a). Behavioral Disinhibition
§ 10-10(b). Psychotic Behaviors
§ 10-10(b)(1). Delusions
§ 10-10(b)(2). Epilepsy Association
§ 10-10(b)(3). Pseudoseizure and Unusual Movement Disorder
§ 10-11. Affective Disorders
§ 10-11(a). Mania
§ 10-11(b). Depression
§ 10-11(c) Major Depressive Disorder
§ 10-12. Obsessional Illness
§ 10-13. Dementia
§ 10-14. External Factors
§ 10-14(a). Age
§ 10-14(b). Environmental Factors
§ 10-14(c). Preinjury Psychosis or Neurosis
§ 10-14(d). Preexisting Circumstances
§ 10-14(e). Compensation and Litigation
§ 10-14(f). Cerebral Arteriosclerosis and Alcoholism
§ 10-14(g). High Expectations
§ 10-14 (h) Alcohol
§ 10-15. Outcome
§ 10-15(a). Measurement Tools
§ 10-16. Multiaxial Assessment
§ 10-17. DSM-IV and ICD-10 Codes
§ 10-18. Summary
References
Chapter 11
TRAUMATIC BRAIN INJURY AND PSYCHOLOGICAL PAIN
§ 11-1. Introduction
§ 11-2. The Dilemma of Causation
§ 11-2(a). Brain and Behavior, Behavior and Brain?
§ 11-3. Immediate Consequences of CHI
§ 11-3(a). Self-Awareness
§ 11-3(a)(1). Loss of Consciousness
§ 11-3(b). Memory
§ 11-3(b)(1). Post-Traumatic Amnesia
§ 11-3(c). Organization and Confusion
§ 11-3(c)(1). Diagnostic Criteria and Definitions for Delirium
§ 11-3(c)(2). Pathophysiology and Delirium
§ 11-3(d). Patient Irritability and Anger
§ 11-3(d)(1). Diagnostic Criteria
§ 11-3(e). Plathophysiology of CHI Post-Damage Aggressive Behavior
§ 11-3(f). Nerotransmitters and CHI
§ 11-4. Post-Concussive Syndromes
§ 11-4(a). Definitions and Diagnosis for Post-Concussive Syndrome (PCS)
§ 11-4(b). Prevalence
§ 11-4(c). Pathophysiology
§ 11-4(d). Psychological and Psychodynamic Aspects of PCS
§ 11-5. Post-Traumatic Stress Disorder
§ 11-5(a). History
§ 11-5(b). Definitions and Diagnoses
§ 11-5(c). PTSD and Continues Stress
§ 11-5(d). Pathophysiological Possibilities for PTSD
§ 11-5(e). Psychosocial and Dynamic Processes in PTSD
§ 11-5(f). Avoiding the Event
§ 11-5(g). Avoidance, LOC, and Memory, Some Impairment Caveats
§ 11-5(h). Increased Arousal, Psychosocial and Psychodynamic Aspects
§ 11-6. Depression
§ 11-6(a). Definitions and Diagnoses
§ 11-6(b). Prevalence
§ 11-6(c). Potential Biological Precipitants for Depression
§ 11-6(d). Psychosocial and Psychodynamic Aspects of CHI-Associated
Depression
§ 11-7. Mania
§ 11-7(a). Definitions and Diagnoses
§ 11-7(b). Prevalence
§ 11-7(c). Potential Biological Precipitants for Mania
§ 11-7(d). Psychodynamic Aspects of Mania
§ 11-8. Anxiety
§ 11-8(a). Definitions and Diagnoses
§ 11-8(b). Prevalence
§ 11-8(c). Potential Biological Correlates for Anxiety
§ 11-8(d). Psychosocial and Psychodynamic Aspects of CHI and Anxiety
§ 11-9. Where Have We Been?
References
Chapter 12
NEUROPSYCHOLOGICAL ASSESSMENT
§ 12-1. Definitions
§ 12-2. History
§ 12-3. Role of Neuropsychological Testing
§ 12-4. Advantages of Neuropsychological Testing
§ 12-5. Behavior
§ 12-5(a). Intellectual Functioning
§ 12-5(a)(1). Wechsler Adult Intelligence Scale (WAIS)
§ 12-5(b). Memory Assessment
§ 12-6. Comprehensive Neuropsychological Test Batteries
§ 12-6(a). Receptive Functions
§ 12-6(b). Attention
§ 12-6(c). Verbal Processes
§ 12-6(d). Visual Processes
§ 12-6(e). Motor Processes
§ 12-6(f). Action Planning and Sequence
§ 12-6(g). Emotionality
§ 12-6(g)(1). The MMPI-2
§ 12-7. Measuring Abilities
§ 12-8. Basic Assumptions in Neuropsychological Testing
§ 12-9. The Neuropsychological Examination
§ 12-9(a). Issues in Neuropsychological Evaluations
§ 12-10. Deficits After Minor Head Injury
§ 12-11. Differentiation Between Organic and Functional (Psychological) Impairments
§ 12-11(a). Malingering
§ 12-11(b). Deficit Faking
References
Chapter 13
PSYCHOSOCIAL IMPLICATIONS
§ 13-1. Introduction
§ 13-2. Measurement Tools
§ 13-2(a). Glasgow Outcome Scale
§ 13-2(b). Rappaport Disability-Rating Scale
§ 13-2(c). Rancho Los Amigos Scale
§ 13-2(d). Return to Work
§ 13-3. Social Impairments
§ 13-4. Rehabilitation of the Head-Injured
§ 13-4(a). Multidisciplinary Approach
§ 13-4(b). Medical-Physical Restoration
§ 13-4(c). Cognitive Remediation
§ 13-4(c)(1). Denial
§ 13-4(d). Behavioral Management
§ 13-4(e). Resocialization
§ 13-4(f). Family Support
§ 13-4(g). Academic and Occupational Performance
§ 13-4(g)(1). Counseling
§ 13-5. Sexual Dysfunction
§ 13-5(a). Incidence
§ 13-5(b). Problems in Rehabilitation
§ 13-5(c). Assessment
§ 13-5(d). Sexual Orientation
§ 13-5(d)(1). Legalities
§ 13-6. Success of Rehabilitation Efforts
§ 13-6(a). Issue of Remolding Behavior
§ 13-6(b). Plasticity of the Brain
§ 13-7. Economic Issues
§ 13-8. Therapy
§ 13-9. Summary
References
Chapter 14
TREATMENT AND PREVENTION
§ 14-1. Introduction
§ 14-2. Early, Immediate, Post-Accident Management
§ 14-2(a). Pre-Hospital Treatment
§ 14-2(b). Emergency Room Treatment
§ 14-2(b)(1). Early Medication Evaluation and Use
§ 14-2(b)(2). Importance of Skull Fracture Detection and Follow-up Neuroimaging
§ 14-2(b)(3). Nutritional Support
§ 14-2(c). Surgical Treatment
§ 14-2(c)(1). Scalp Wounds
§ 14-2(c)(2). Fractures
§ 14-2(c)(3). Removal of Intracranial Masses
§ 14-2(c)(4). Management of Seizures
§ 14-3. Late, Immediate Post Acute Management
§ 14-3(a). Pharmacotherapy
§ 14-3(a)(1). Cognitive Functions
§ 14-3(a)(1)(a) Memory
§ 14-3(a)(2). Emotional Changes
§ 14-3(a)(2)(a). Aggression and Irritability
§ 14-3(a)(2)(b). Unaccounted for Laughing and Crying
§ 14-3(a)(2)(c). Depression
§ 14-3(a)(2)(d). Mania
§ 14-3(a)(3). Headache
§ 14-3(b). Nonmedical and Alternative Treatments
§ 14-3(b)(1). Physical Therapy
§ 14-3(b)(2). Biofeedback
§ 14-3(b)(3). Progressive Relaxation
§ 14-3(b)(4). Psychomotoric Treatment
§ 14-3(b)(5). Chronic Pain Management
§ 14-3(c). Psychological Intervention
§ 14-3(c)(1). Identification of the Problem
§ 14-3(c)(2). Support
§ 14-3(c)(3). Neuropsychological Rehabilitation
§ 14-3(c)(3)(a). Cognitive Remediation
§ 14-3(c)(3)(b). Psychosocial Adjustment to Disability
§ 14-3(c)(3)(c). Effects of Treatment Delays
§ 14-3(c)(3)(d). Model Programs
§ 14-3(c)(3)(e). Accommodation
§ 14-3(d). Physical Rehabilitation
§ 14-3(e). Education
§ 14-3(f). Lifecare Planning
§ 14-4. Cognitive Rehabilitation
§ 14-4(a). Arousal and Attention
§ 14-4(b). Orientation
§ 14-4(c). Memory
§ 14-4(d). Language
§ 14-4(e). Visual Perceptual Functioning
§ 14-4(f). Executive Functions
§ 14-5. Chronic Pain Management
§ 14-5(a). Posttraumatic Stress and Pain
§ 14-5(b). Chronic Pain Patients and Therapists
§ 14-5(b)(1). A Cognitive Model of Pain and Suffering
§ 14-5(b)(2). Constructs and Therapy
§ 14-5(b)(2)(a). Cognitively Toned Pain and Suffering
§ 14-5(b)(2)(b). Relaxation Training and Hypnosis
§ 14-6. Psychotherapy
§ 14-6(a). Consequences of Head Trauma and Treatment Limitations
§ 14-6(b). Presenting Problems
§ 14-6(c). Patients and Therapists at Work
§ 14-6(d). Organizing Therapeutic Times and Places
§ 14-6(e). Bibliographic Aids to the Therapist
§ 14-7. Patient and Family Education, Treatment for Family Members
§ 14-7(a) Prophylactic Hypothermia
§ 14-7(b) Infection Prophylaxis
§ 14-7(c) Deep Vein Thrombosis Prophylaxis
§ 14-7(d) Cerebral Perfusion Thresholds
References
Chapter 15
NURSING PERSPECTIVES
§ 15-1. Recognition of the Problem
§ 15-2. Nurses' Emerging Roles
§ 15-3. Remaining Professionally Centered
§ 15-4. The Nursing Assessment
§ 15-5. Evaluating Recovery
§ 15-6. Payer Systems
§ 15-7. Interface with the Legal World
§ 15-8. Hidden Agenda Factors to Consider
References
Chapter 16
FORENSIC ISSUES
§ 16-1. Introduction
§ 16-2. Legal Recourses in Head-Injury Cases
§ 16-3. Lawyer's Role
§ 16-4. History
§ 16-5. Diagnostic "Look-alikes"
§ 16-5(a). Compensation Neurosis
§ 16-5(a)(1). Characteristics of Compensation Neurosis
§ 16-5(a)(2). History of Compensation Neurosis
§ 16-5(a)(3). Social Aspects
§ 16-5(b). Malingering
§ 16-5(b)(1). Suspicion of Malingering
§ 16-5(b)(2). Differentiation of Malingering
§ 16-5(b)(3). Coaching
§ 16-5(b)(4). Episodic Malingering
§ 16-5(b)(5). Determination
§ 16-5(b)(6). Personal Bias
§ 16-5(b)(7). Lying
§ 16-5(c). Factitious Illness
§ 16-6. Expert Testimony
§ 16-6(a). Treating Physician Testifying as Patient Advocate
§ 16-7. Forensic Examination
§ 16-7(a). Neurological
§ 16-7(b). Neuropsychological
§ 16-7(c). Vocational Expert
§ 16-7(c)(1). Occupational Consequences
§ 16-7(d). Physiatrist
§ 16-7(e). Testimony by the Patient
§ 16-7(f). Determination of Preinjury Status
§ 16-8. Tips for Plaintiffs' Lawyers
§ 16-9. Tips for Defense Lawyers
§ 16-9(a) Malingering--Considerations for the Defense Lawyer
References
Additional Reading
Chapter 17
FORENSIC EVIDENCE IN HEAD INJURY: NEUROLOGIC EVIDENCE IN HEAD-INJURY LITIGATION
§ 17-1. Introduction
§ 17-2. Forensic Evidence
§ 17-2(a). Accident Reports
§ 17-2(b). Emergency Medical Treatment and Hospitalization Records
§ 17-2(c). Past Medical Records and Medical Subsequent Treating Physician Records
§ 17-2(d). Employment and Educational Records
§ 17-2(e). Independent Medical Evaluations
§ 17-2(f). Psychological Evaluations
§ 17-3. Summary
Chapter 18
THE INSURANCE ANALYSIS OF HEAD INJURY: NEUROLOGIC ASPECTS OF TESTS AND EXAMINATIONS IN HEAD-INJURY AND RELATED CHRONIC PAIN SYNDROME CLAIMS
§ 18-1. Introduction
§ 18-2. Defense Against Claims of Neurologic Injury
§ 18-2(a). Team Approach
§ 18-2(a)(1). Patient History
§ 18-2(b). Examination and Testing
§ 18-2(b)(1). Determination of the Type of Symptoms
§ 18-2(b)(2). Determination of the Severity of Symptoms
§ 18-2(b)(2)(a). Brain Mapping and Electroencephalography
§ 18-2(b)(2)(b). Computed Tomographic Scanning
§ 18-2(b)(2)(c). Magnetic Resonance Imaging
§ 18-2(b)(2)(d). Other Neurological Techniques
§ 18-2(b)(3). Final Evaluation
§ 18-2(b)(3)(a). The Usefulness of Neuropsychological Tests
§ 18-3. Defense Against Claims of Malpractice
§ 18-4. Summary
References
Chapter 19
AUTONOMIC NERVOUS SYSTEM MONITORING IN CLOSED HEAD INJURY PATIENTS
§ 19-1. Introduction
§ 19-1(a). Brain Stem Injury
§ 19-1(b). Hemispheric Injury
§ 19-2. Sample Patient Data
§ 19-3. Autonomic Nervous System (ANS) Function Testing
§ 19-4 Closed-Head Injury and Excess Sympathetic Stimulation
§ 19-5 Closed-Head Injury, ANS, and Rehabilitation
§ 19-6 Conclusion
References
Chapter 20
GOALS OF THERAPY
§ 20-1 Interdisciplinary Approaches to Therapy for Individuals with Brain Injury
§ 20-2 Neuropsychology and Rehabilitation Psychology
(a) Areas of Practice
(b) Outcomes
§ 20-3 Occupational Therapy
(a) Areas of Practice
(b) Outcomes
§ 20-4 Physiatry
(a) Areas of Practice
(b) Outcomes
§ 20-5 Physical Therapy
(a) Areas of Practice
(b) Outcomes
§ 20-6 Speech Language Pathology
(a) Areas of Practice
(b) Outcomes
§ 20-7 Community Integration Therapist/Recreation Therapist/Therapeutic Recreation
(a) Areas of Practice
(b) Outcomes
§ 20-8 Vocational Rehabilitation
(a) Areas of Practice
(b) Outcomes
§ 20-9 Rehabilitation: Aging and Recovery After Closed-Head Injury
References
Chapter 21
COMA
§ 21-1 Classifying Comatose Patients After Resuscitation
§ 21-2 Predicating Poor Outcomes in Comatose Patients
(a) Discussions About the Level of Care
(b) Assessment of Neurologic Prognosis
§ 21-3 International Brain Research Foundation
§ 21-4 One Hypothetical Example of a Neuroscience Program for CHI
References
Chapter 22
SPORT-RELATED TRAUMA AND CLOSED-HEAD INJURY (CHI)
§ 22-1 Hidden Brain Trauma and Sport-Related Injury
§ 22-2 Sport-Related Clinical Depression
§ 22-3 Chronic Traumatic Encephalopathy
References
Chapter 23
BLAST BRAIN INJURIES
§ 23-1 Introduction
§ 23-2 Causes of TBI in Military
§ 23-3 Classification of Explosives
§ 23-4 Effects of Explosives
§ 23-5 Medium in Which the Explosion Occurs
§ 23-6 Severity of TBI
§ 23-7 Classification of Blast Injuries
(a) Primary Blast Injury
(i) Ear Damage
(ii) Pulmonary Damage
(iii) Gastrointestinal Damage
(iv) Cardiac Injury
(v) Brain Injury
(a) Concussion Syndrome and Hemorrhage
(i) Traumatic Brain Injury
(ii) Diagnostic Approaches for bTBI
(iii) Complications from Head Injury
(b) Cerebral Air Embolism
(b) Secondary Blast Injury
(c) Tertiary Blast Injury
(d) Quaternary Injury
(e) Immediate Death
§ 23-8 Evaluation and Management
§ 23-9 PCS in Military
§ 23-10 Clinical Case Presentation
References
