Neuropsychology focuses on diagnosing changes in cognition and behavior after known or suspected occurrences of brain damage. This specialized area of clinical neuroscience deals specifically with the nature of abnormal brain-behaviors and understanding how such developments influence the daily life of afflicted individuals.
Neuropsychologists treat a wide variety of patients, ranging from children with suspected learning disabilities to older individuals with symptoms of dementia. Many of them treat patients with traumatic brain industries.
Traumatic brain injuries (TBIs), or intracranial injuries, occur when an outside source wounds the brain. Classification of intracranial injuries depends on severity, type—closed or penetrating—and location—whether the injury is localized or widespread. Traumatic brain injuries are a highly prevalent cause of death and disability, especially in children. Causes of these types of injuries include falls and collisions associated with playing contact sports or other types of vigorous physical activities, vehicle accidents, and violence. The actual origin of injury is by either direct impact or acceleration. Primary injury occurs at the time of impact or acceleration, while secondary injuries take time to develop after the primary injury occurs. Secondary injuries can be just as detrimental as primary ones, and even more so because they can worsen the effects of the initial injury because of changes in cerebral blood flow and pressure inside the skull.
These injuries can cause a large array of physical, cognitive, emotional, and behavioral influences resulting in outcomes ranging from total recovery to permanent disability or death. Treatments also vary depending on the type and severity of the injury, and can involve negligible physical therapy sessions or medications and surgery. The Glasgow Coma Scale is the most widely used organism of classifying TBI severity. It evaluates a person’s level of consciousness on a scale of 3 to 15, relying on verbal, motor, and eye-opening reactions to stimuli to place them on the scale. Professionals in the neurosciences field agree that individuals placed 13 or above have mild TBI severity, those placed 9 through 12 are moderate, and 8 or below are severe.
Neuropsychologists determine the extent of injuries through evaluations. Such session are necessary to understand which brain functions the injury affected and how, as well as which ones remain unaltered. In certain situations such as mild injuries, this examination may be necessary to decide if a person really received a TBI or not because many symptoms of such injuries are identical to other ailments such as stress, consequences of medication, or depression.
Understanding the patient’s circumstances and customizing the evaluation components is vital to proper diagnosis and treatment. While each examination is customized and unique, the initial steps of such an examination includes giving the patient a series of standardized psychometric tests so that they can establish a normal cognition baseline from which they can later compare results from to those of known patients with varied brain diseases and injuries.
The next stage of the examination includes an evaluation of orientation, general intellectual functioning, their ability to learn and remember new information, the quality of their attention and concentration spans, their language abilities, their visuoperception and sensorimotor functioning, their abilities to self-monitor and correct their own behavior, past academic achievements, and their personality functioning.
These examinations normally take place while the patient is hospitalized, and can last anywhere from three to six hours in duration. The advantage to taking such an extensive amount of time for the examination is that the neuropsychologist gains a fuller understanding of the patient’s abilities while directly observing them.
Once the evaluation is complete, the neuropsychologist interprets the results of the various examinations and creates an in-depth evaluation which includes a differential diagnosis of neurobehavioral functioning. This creates a better profile of the patient’s condition and a more reliable approach for doctors to diagnose it properly. For instance, it can help clear up any uncertainties regarding a patient’s cognitive losses associated with dementia from those experienced with significant depression, or uncover a residual confusion that could also be aphasia. Accurate diagnosing ensures that the patient receives appropriate rehabilitation resources, and helps medical professionals treating the patient to understand the nature and severity of any deficits and the functional complications created by them in the patient’s daily life. This information is useful so that doctors can prepare discharge instructions properly and educate the patient as well as his or her family members on how to deal with these issues.
Neuropsychologists continue to work towards their goals of understanding traumatic brain injuries and learning how to cope with the consequences of them. Proper diagnosis through a thorough neuropsychological exam helps neuropsychologists create a plan of attack; what rehabilitation services the patient will benefit the most from, what changes they will need to make in their daily lives in order to function with the injury, and how the individual will need the support of family and friends to deal with their injuries. Neuropsychologists also provide education and support to those closest to the injured patient on how to manage their loved one’s condition. Neuropsychologists hope to better understand the conditions and consequences of their patient’s injuries, and try to make their lives as rich as possible.
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