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Neuropsychological Evaluation of Traumatic Brain Injury: The Definitive Guide

By: Dr. Emin Gharibian
Tel: 248-770-4906
Email Dr. Gharibian

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Traumatic Brain Injury (TBI) is getting more attention than ever before. Media outlets have done a great job at highlighting the impact of TBI and Chronic Traumatic Encephalopathy (CTE) on football players. This extra attention and research are great news for anyone that's experienced a TBI.

The reality is that TBI and CTE are not only found in football players. According to the Centers for Disease Control (CDC), in 2014, 2.87 million people ended up in an emergency room because of a TBI.

Neuropsychological evaluations for traumatic brain injury are one of the more common types of evaluations that we complete. Most of our patients are very anxious when they come and see us for an evaluation.

We want to help ease your anxiety and provide you with more information on what a TBI is and how it can impact you.

The goal of this blog post is to talk about the leading causes of TBI, how a TBI is diagnosed, how a TBI impacts your brain, and how a neuropsychological evaluation for a traumatic brain injury can help you.

What are the leading causes of Traumatic Brain Injury (TBI)?

The typical causes of TBI stay fairly consistent year over year.

Here are some stats from 2013:

  • Falls, especially among young children and older adults, make up around 47% of head injuries.
  • Blunt force trauma makes up around 15% of head injuries.
  • Motor vehicle accidents make up around 14% of all head injuries.
    • 65% are the result of car accidents.
    • 15-20% are the result of motorcycle accidents.
    • 10% are from bicycle accidents.
  • Assaults (including child abuse) make up around 9% of head injuries.

leading causes TBI chart photo

You can read more about the leading causes of TBI here and here.

Every year in the United States over 50,000 people die as a result of a TBI. TBI's make up around 1/3 of all injury-related deaths.

Around 80,000 to 90,000 people a year experience a life-long disability as a result of a TBI.

We didn't include all of these stats to scare you. We want to show you how common a TBI is and how many people it impacts every single year!

What are the types of Traumatic Brain Injury (TBI)?

TBIs are broken down into three types:

  1. Mild TBI (75-80% of cases)
  2. Moderate TBI (10-15% of cases)
  3. Severe TBI (10% of cases)

In order to determine the severity of the TBI, doctors use three criteria when they do their assessment in the emergency room.

  1. The Glasgow Coma Scale (GCS), which is determined when the person first arrives at the hospital.
  2. Loss of consciousness (LOC)
  3. Post-Traumatic Amnesia (PTA), which is a state of confusion and memory loss right after a TBI. PTA occurs because there is an impairment in attention and concentration, which are required to place new information into memory storage.

We've made a simple chart below to help break down how doctors determine the grade of the TBI.

Classification system for TBI chart photo

What is Post-Traumatic Amnesia (PTA)?

Post-Traumatic Amnesia (PTA) is a state of confusion and memory loss right after a traumatic brain injury. PTA occurs because there are impairments in attention and concentration, which are required to place new information into memory storage.

Here are some of the common signs of PTA:

  1. Disorientation and confusion
  2. Anterograde amnesia (difficulty forming new memories)
  3. Retrograde amnesia (difficulty recalling old memories)
  4. Distractibility
  5. Difficulties with alertness

PTA causes individuals to have “islands of memory”. They can remember bits and pieces of the event but don't have a continuous recollection of what happened.

They also have a hard time forming new memories (anterograde amnesia) and have difficulty remembering information BEFORE the event because of the disruption to their memory system (retrograde amnesia).

PTA ends AFTER the person has continuous awareness of their environment and is able to form new memories.

PTA is an important sign to be aware of because the length of the PTA can help us determine the severity of the TBI. The longer the PTA, the higher the likelihood that the TBI is causing memory impairment.

Here is what PTA looks like following a closed head injury.

post traumatic amenisia chart photo

What are The Signs of a Mild Traumatic Brain Injury (mTBI)?

Mild traumatic brain injuries (mTBI) make up around 75-80% of all TBI cases. . . .

. . .Continue to read rest of article (PDF).

Dr. Emin Gharibian, PsyD is a Clinical Psychologist specializing in Neuropsychology with over 10 years of experience in assessing, treating, and consulting on psychological disorders. He specializes in providing comprehensive psychological and neuropsychological evaluations for a variety of conditions including dementia, Alzheimer.s disease, complications from a stroke, traumatic brain injury, concussions, learning disabilities, ADHD, and PTSD in clinical, civil, and criminal cases.

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