Abstract
TBI rehabilitation case is a case example of traumatic brain injury (TBI) using neuropsychological (NP) and neurological evaluations and follow-ups to assist the patient in helping her reach her long-term rehabilitation goals. The largest obstacles to achieving success included the patient’s defensiveness and psychological reactions to her situation, fatigue, and higher-level cognitive challenges which were detected on neuropsychological assessment.
Key Questions
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1.
What are the benefits of conducting a neuropsychological examination, and how can this data be used to help the physiatrist manage the overall care?
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How can the neuropsychologist and physiatrist collaborate effectively to help the patient reach her neurorehabilitation goals?
This case study helps to demonstrate the value of NP testing in treatment of TBI, as well as the value of establishing a strong collaborative relationship between the neuropsychologist and the physiatrist specializing in brain injury rehabilitation.
Keywords
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References
Lezak MD, Howieson DB, Bigler ED, Tranel D. Neuropsychological assessment. New York: Oxford University Press; 2012.
Brooks N, McKinlay W, Symington C, Beattie A, Campsie L. Return to work within the first seven years of severe head injury. Brain Injury. 1987;1(1):5–19.
Thomsen IV. Late outcome of very severe blunt head truma: a 10–15 year second follow-up. J Neurol Neurosurg Psychiatry. 1984;47:260–8.
Kolakowsky-Hayner SA, Miner KD, Kreutzer JS. Long-term life quality and family needs after traumatic brain injury. J Head Trauma Rehabil. 2001;16(4):374–85.
Ponsford JL, Olver JH, Curran C, Ng K. Prediction of employment status 2 years after traumatic brain injury. Brain Injury. 1995;9(1):11–20.
Borgaro SR, Baker J, Wethe JV, et al. Subjective reports of fatigue during early recovery from traumatic brain injury. J Head Trauma Rehabil. 2005;20:416–25.
Cantor JB, Bushnik T, Cicerone K, Dijkers MP, Gordon W, Hammond FM, Kolakowsky-Hayner SA, Lequerica A, Nguyen M, Spielman LA. Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury: a NIDRR TBI model system module study. J Head Trauma Rehabil. 2012;27(6):E1–14.
Lucas S, Hoffman JM, Bell KR, Dikmen S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. 2014;34(2):93–102.
Godbolt AK, Stenberg M, Jakobsson J, Kimmo S, Krakau K, Stalnacke FM, DeBoussard CN. Subacute complications during recovery from severe traumatic brain injury: frequency and associations with outcome. BMJ Open. 2015;5(4):e007208.
Barnett BP, Singman EL. Vision concerns after mild traumatic brain injury. Curr Treat Options Neurol. 2015;17(2):329.
Gardani M, Morfiri E, Thomson A, O-Neill B, McMillan T. Evaluation of sleep disorders in patients with severe traumatic brain injury during rehabilitation. Arch Phys Med Rehabil. 2015;15:418–9.
Ponsford JL, Sinclair KL. Sleep and fatigue following traumatic brain injury. Psychiatr Clin North Am. 2014;37(1):77–89.
Seel RT, Kreutzer JS, Rosenthal M, Hammond FM, Corrigan JD, Black K. Depression after traumatic brain injury: a national institute on disability and rehabilitation research model systems multicenter investigation. Arch Phys Med Rehabil. 2003;84:177–84.
Deb S, Lyons I, Koutzoukis C, Ali I, McCarthy G. Rate of psychiatric Illness 1 year after traumatic brain injury. Am J Psychiatry. 1999;156:374–8.
Kreutzer JS, Seel RT, Gourley E. The prevalence and symptom rates of depression after traumatic brain injury: a comprehensive examination. Brain Injury. 2005;15(7):563–76.
Varney NR, Martzke JS, Roberts RJ. Major depression in patients with closed head injury. Neuropsychology. 1987;1(1):7–9.
Lezak M. Relationship between personality disorders, social disturbances, and physical disability following traumatic brain injury. J Head Trauma Rehabil. 1987;2(1):57–69.
Dickmen SS, Bombardier CH, Machamer JE, Fann JR, Temkin NR. Natural history of depression in traumatic brain injury. Arch Phys Med Rehabil. 2004;85(9):1457–64.
Jorge RE, Robinson RG, Arndt SV, Starkstein SE, Forester AW, Geisler F. Depression following traumatic brain injury: a 1 year longitudinal study. J Affect Disord. 1993;27(4):233–43.
MacNiven E, Finlayson MA. The interplay between emotional and cognitive recovery after closed head injury. Brain Injury. 1993;7:241–6.
Malec JF, Moessner AM. Self-awareness, distress, and post-acute rehabilitation outcome. Rehabil Psychol. 2000;45:227–41.
Rosenthal M, Christensen BK, Ross TP. Depression following traumatic brain injury. Arch Phys Med Rehabil. 1998;79:90–103.
Cantor JB, Ashman TA, Schwartz ME, Gordon WA, Hibbard MR, Brown M, Spielman L, Charatz HJ, Cheng Z. The role of self-discrepancy theory in understanding post-traumatic brain injury affective disorders: a pilot study. J Head Trauma Rehabil. 2005;20(6):527–43.
Lam B, Middleton LE, Masellis M, Stuss DT, Harry RD, Kiss A, Black SE. Criterion and convergent validity of the Montreal cognitive assessment with screening and standardized neuropsychological testing. J Am Geriatr Soc. 2013;61(12):2181–5.
Pendlebury ST, Markwick A, deJager CA, Zombini G, Wilcock GK, Rothwell PM. Differences in cognitive profile between TIA, stroke and elderly memory research subjects: a comparison of the MMSE and MoCA. Cerebrovasc Dis. 2012;34(1):48–54.
Breceda EY, Dromerick AW. Motor rehabilitation in stroke and traumatic brain injury: stimulating and intense. Curr Opin Neurol. 2013;26(6):595–601.
Trexler L, Webb PM, Zappala G. In: Christensen AL, Uzzell Barbara P, editors. Strategic aspects of neuropsychological rehabilitation. As seen in brain injury and neuropsychological rehabilitation: international perspectives. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1994.
Galski T, Ehle HT, McDonald MA, Mackevich J. Evaluating fitness to drive after cerebral injury: basic issues and recommendations for medical and legal communities. J Head Trauma Rehabil. 2000;15:895–908.
Dawson JD, Uc EY, Anderson SW, et al. Neuropsychological predictors of driving errors in older adults. J Am Geriatr Soc. 2009;58:1090–6.
Sigurdardottir S, Andelic N, Roe C, Schanke AK. Cognitive recovery and predictors of functional outcome 1 year after traumatic brain injury. J Int Neuropsychol Soc. 2009;33:202–10.
Wilde EA, Whiteneck GG, Bogner J, Bushnik T, Cifu DX, Dikmen S, French L, Giacino JT, Hart T, Malec JF, Millis SR, Novack TA, Sherer M, Tulsky DS, Vanderploeg RD, von Steinbuechel N. Recommendations for the use of common outcome measures in traumatic brain injury research. Arch Phys Med Rehabil. 2010;91:1650–60.
Vanderploeg RD, Collins RC, Sigford B, Date E, Schwab K, Warden D. Practical and theoretical considerations in designing rehabilitation trials: the DVBIC cognitive-didactic versus functional-experiential treatment study experience. J Head Trauma Rehabil. 2006;21:179–93.
Christensen AL, Uzzell BP. International handbook of neuropsychological rehabilitation. New York: Kluwer Academic/Plenum Press; 2000.
Parker RS. Traumatic Brain Injury and Neuropsychological Impairment: sensorimotor, cognitive, emotional, and adaptive problems of children and adults. New York: Springer-Verlag; 1990.
Mitrushina MN, Boone KB, D’Elia LF. Handbook of normative data for neuropsychological assessment. New York: Oxford University Press; 1999.
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Chapter Review Questions
Chapter Review Questions
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1.
In this case, the diagnosis of TBI was already known. Given this information, how was it useful to obtain neuropsychological testing data, and how did this guide the treatment recommendations for the patient’s outpatient treatment, particularly given that she appeared so “high-level” and obtained some “average” scores?
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Why was it important to recommend that a more comprehensive neuropsychological test be given as opposed to providing a basic mental status examination for this patient? Are there times when administering mental status examinations can be useful?
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Why was it important for the physiatrist to have some knowledge on treatment of mood disturbances, and when would it have been a good idea to refer out to a psychiatrist?
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How does collaboration with a neuropsychologist help a physician better monitor a patient’s cognitive progress and rehabilitation process? How does it help synergize the management of mood disturbances?
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Backhaus, S.L., Durand-Sanchez, A. (2019). Traumatic Brain Injury Rehabilitation Case Study. In: Sanders, K. (eds) Physician's Field Guide to Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8722-1_26
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