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January 22, 2020 by PILLI Law

TBI and Neuropsychological Testing

Traumatic brain injury (TBI) is being diagnosed with greater frequency in the United States.  TBI awareness has increased amongst the general public and the medical community based on studies of chronic traumatic encephalopathy (CTE) in professional athletes and combat-related injuries in military personnel.  Past studies tell us that as many as 60% of TBIs go undiagnosed. For example, one study reported that the diagnosis is routinely missed in the emergency room setting by emergency department personnel who are more focused on visible injuries.  With greater awareness comes more attention from the scientific community and the media. As a result, the reported incidence of brain damage from traumatic causes has increased.

An experienced brain injury lawyer can easily tell you about all of the challenges associated with traumatic brain injuries, including medical providers who failed to make the diagnosis, the lack of objective testing to prove the diagnosis, and difficulty in assessing the degree of impairment.  Add to these challenges the fact that, when diagnosed, organic brain damage from an accident or injury is often misdiagnosed as posttraumatic stress disorder (PTSD) or depression.  

We now know that many types of injuries can cause permanent brain damage in addition to car and truck accidents, such as electrocution, explosions, and falls.  Studies show that even one concussion can cause life-long disability. The effects of post-concussion syndrome are just being studied. New studies show that whatever name is used, TBI, post-concussion syndrome or CTE, permanent brain damage increases the risk of early-onset dementia and other progressive neurologic disorders.  The costs associated with brain damage, in terms of lost earnings and future costs of medical care, can be staggering.

Neuropsychological testing has been developed to identify individuals with cognitive and intellectual impairments from brain damage.  These cognitive and intellectual impairments can manifest as changes in emotion, decreased intellect, lack of executive planning, loss of short and/or long term memory, headaches, dizziness, hormonal abnormalities, tinnitus and lack of concentration.  Even so-called mild traumatic brain injury can lead to job loss, household strife and social isolation, so an overlay of depression is often present, further complicating diagnosis and treatment. Speaking of treatment, there is no known treatment for permanent brain injury.  The brain is an unforgiving organ that does not regenerate like other organs.

Neuropsychological testing can be used to identify deviations in cognitive and intellectual functions from the norm.  Unfortunately, most people do not have pre-injury neuropsychological testing to compare with their post-injury test results.  Therefore, post-injury results can only be compared with societal norms. Thus, neuropsychological testing has inherently limited value.

There are a variety of neuropsychological tests available, including the MMPI.  All of these tests are subject to interpretation, such that insurance company lawyers can find a hired gun expert to argue that the results show malingering or fakery.  In many instances, a personal injury victim may find that they are better served by presenting testimony from a neurologist or physiatrist at trial instead of a neuropsychologist.  Ask an experienced brain injury lawyer in Cleveland, OH for advice when treating for a TBI that is the subject of a personal injury lawsuit.

Thanks to Mishkind & Kulwicki for their insight into personal injury claims and brain injuries.

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