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Neuropsychological Assessment of mTBI in Adults

  • Andrew J. GardnerEmail author
  • James Tonks
  • Seb Potter
  • Philip J. Yates
  • Adam Reuben
  • Helen Ryland
  • Huw Williams
Chapter

Abstract

Mild traumatic brain injury (mTBI), comprising 70–80% of all TBIs, is the commonest form of TBI, representing those injuries deemed to be at the lower end of the severity spectrum. In the general population, mTBI may occur as a result of a fall, work-related injury, sport or recreational activity, assault, motor vehicle accident, or any other activity that results in an impact to the head, but in military service, members’ blast-related and combat injuries are a further source of such injuries. There are various classification criteria for determining severity of TBI. mTBI is indicated by a Glasgow Coma Scale (GCS) score of 13–15 at the time of assessment, a duration of loss of consciousness (LOC) of less than 30 minutes, and/or a duration of post-traumatic amnesia (PTA) of less than 24 hours. In terms of the clinical pathology, mTBI is characterized by a diverse range of clinical features, demonstrating tremendous heterogeneity of the underlying pathology. Individuals suffering from mTBI may report a range of enduring1+ symptoms for weeks, months, and even years post-injury. In over 90% of mTBI cases, computed tomography (CT) and structural magnetic resonance imaging (MRI) investigation are unremarkable; however, with the more sophisticated brain function-related techniques abnormalities may be detected. While many mTBIs tend to result in a recovery period of days or weeks, this is not the case for all mTBIs. In some instances, the use of the classification “mild” is a misnomer, particularly for the group of patients that experience a prolonged recovery and meet criteria for persistent concussional symptoms/post-concussion syndrome (PCS). This review will focus on the post-injury cognitive sequelae and neuropsychological assessment in the management of mTBI, in the context of pre-injury characteristics and other post-injury sequelae.

Keywords

mTBI Mild traumatic brain injury Neuropsychological assessment Cognition 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Andrew J. Gardner
    • 1
    Email author
  • James Tonks
    • 2
    • 3
    • 4
  • Seb Potter
    • 5
  • Philip J. Yates
    • 6
  • Adam Reuben
    • 7
  • Helen Ryland
    • 8
  • Huw Williams
    • 8
  1. 1.Priority Research Centre for Stroke and Brain Injury, School of Medicine and Public Health, University of NewcastleCallaghanAustralia
  2. 2.University of Exeter Medical SchoolExeterUK
  3. 3.Haven Clinical Psychology PracticeCornwallUK
  4. 4.University of LincolnLincolnUK
  5. 5.Institute of Psychiatry, Psychology, and Neuroscience, Department of Psychology, King’s College LondonLondonUK
  6. 6.Royal Devon and Exeter Hospital, Mardon Neuro-Rehabilitation CenterExeterUK
  7. 7.Royal Devon and Exeter NHS Foundation Trust, Emergency DepartmentExeterUK
  8. 8.University of ExeterExeterUK

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