Your brain regulates and controls your behaviour, mood, bodily functions, and movements. While it is your body’s central control, damage can lead to significant cognitive and physical disabilities. A traumatic brain injury (TBI) can have long-lasting consequences that could impact you for the rest of your life. Prompt diagnosis and treatment of a brain injury might prevent further damage and improve your outcome. This process might involve multiple professionals, including a neuropsychologist. Here’s some information about how neuropsychologists might be involved in diagnosing and treating traumatic brain injury.
What is traumatic brain injury?
A traumatic brain injury (TBI) is damage to the brain and surrounding tissues caused by a sudden physical force applied externally. This type of injury is one of the most common causes of death and disability in adults. Traumatic brain injuries include many types of injuries that can occur to the brain. The damage can be focal or limited to one brain region or diffuse, which spreads throughout the brain or involves more than one region. TBIs range in severity from mild concussions to severe TBIs that can result in permanent disabilities, coma, or death.
Different types of traumatic brain injuries
Traumatic brain injuries can be closed or open. Closed brain injuries occur when there is an external blow to the head or body that causes damage to the brain without a penetration or skull fracture. These injuries occur because of rapid shaking or forward or backward movements of the brain inside the skull, causing the brain tissue and blood vessels to bruise and tear. Closed traumatic brain injuries typically result from car accidents, sports, and falls. Shaking a baby is another cause of child abuse.
A penetrating injury occurs when an object penetrates through the skin and skull and damages the brain. This type of injury can occur when debris from a car accident penetrates the head and skull or a person is shot or stabbed.
Brain injury types include the following:
- Concussion. Generally mild, closed brain injury caused by rapid shaking
- Diffuse axonal injury. Rapid shaking leads to tearing of the axons in the brain, resulting in more severe damage than a concussion and often results in coma
- Contusion. Bruise on the brain under the impact site that can cause swelling and further damage without prompt treatment
- Hematoma. Collection of blood clots that can increase pressure and cause worsening damage if not relieved
- Haemorrhage. Rapid bleeding from a torn artery leading to a sudden pressure increase
Brain injuries are classified as mild, moderate, or severe. Mild injuries generally resolve within a few weeks and allow people to return to normal activities. Moderate TBI results in more damage and may involve a loss of consciousness lasting from more than 30 minutes to 24 hours. Severe TBIs may result in lifelong disabilities, coma, or death and may involve a loss of consciousness of 24 hours or longer.
Recovery following a TBI
Brain cells can’t regenerate after they are damaged or destroyed. However, people can still recover in some cases. In some cases, other brain regions can make up for what the damaged area lost. The brain might need to be trained so that it can reroute functions and information around the damaged areas. The recovery period and extent will depend on the unique facts of a case, and recovering from a severe TBI may require lifelong treatment and rehabilitation.
Neuropsychology and its role in TBIs
Neuropsychology is a specialised field of psychology that studies the relationship between behaviour and the brain by studying the brain’s function and structure and how they translate into emotions, cognition, and behaviour. A neuropsychologist might work with patients who have suffered all types of brain injuries, including TBIs and those resulting from disorders or medical conditions.
Neuropsychological assessment
The diagnostic process for TBI might include a neuropsychological assessment. After a brain injury, cognitive, emotional, and physical changes might not be readily apparent. Neuropsychological assessments can identify brain areas that have been damaged and the extent of the damage. During an assessment, a neuropsychologist performs multiple tests to check for changes in learning, memory, focus, reasoning, motor skills, spatial perception, and language.
The traumatic brain injury assessments might involve brain imaging, computerised tests, observations, and hands-on assessments. The neuropsychologist will talk to the patient (if possible) and their family members to gather information and analyse it with the test results to make a diagnosis. A neuropsychologist will administer tests to look for memory, language, executive functioning, and language deficits, which can aid in creating a thorough treatment plan. These assessments can also be used to track the patient’s progress as they undergo rehabilitation to determine whether they are improving or if they have developed additional deficits that require other therapies.
How neuropsychologists work in TBI treatment teams
Patients with moderate to severe TBIs may have treatment teams that include multiple types of professionals, including medical doctors, neuropsychologists, speech-language therapists, recreational therapists, occupational therapists, nurses, social workers, and others. The neuropsychologist works directly with patients and families to develop comprehensive and individualised treatment plans to address the cognitive deficits resulting from the injury. The plan might include psychotherapy, cognitive rehabilitation, lifestyle changes, and medication management.
Once the assessment is completed, the neuropsychologist will discuss the specific complications the patient is dealing with and how they can be addressed. They will develop a treatment plan to facilitate the patient’s recovery. Full recovery might not be possible for a severe tbi, but recovery can still include an improvement over time to achieve greater independence.
During the process, the neuropsychologist will work with the patient and family to help them adjust to life after a tbi. this might include making sure the patient receives help through accessing resources with completing the activities of daily living, transportation, or meeting other needs.
Cognitive rehabilitation
Cognitive rehabilitation focuses on improving the patient’s ability to function cognitively and reduces the effects of the patient’s brain injury on day-to-day life. This treatment might include several techniques, including problem-solving, attention-building, and memory training activities.
Psychotherapy
Another important component of brain injury treatment is psychotherapy. Patients with TBIs may experience psychological, emotional, and behavioural changes, including irritability, personality changes, stress, depression, and anxiety. Psychotherapy helps patients learn new coping mechanisms to improve their life quality.
Medication management
Some TBI patients may also receive medications to treat certain symptoms of TBIs, including depression, psychosis, or anxiety. They might also need medication to treat seizures caused by their brain injuries or stimulants to improve focus and attention.
Lifestyle changes
A neuropsychologist may recommend lifestyle changes to help the patient recover from a TBI. Exercise and dietary changes may be a part of this because research has shown that they can enhance cognitive and physical functioning. Certain nutrients have been shown to improve cognitive functioning, so dietary changes might be recommended in addition to exercise.
Neuropsychologists are often involved in the diagnosis and treatment of traumatic brain injuries. They might conduct neuropsychological assessments to identify the deficits that need to be addressed and develop thorough, individualised treatment plans. A neuropsychologist will work closely with other members of the patient’s treatment team to deliver a holistic therapeutic approach that facilitates recovery. A patient’s treatment will depend on the severity and type of brain injury and could be lifelong in severe cases. Early intervention is critical for treating TBIs. patients who receive prompt treatment may avoid worsened injuries and enjoy a better prognosis.
Final thoughts
If you suspect a loved one may have suffered a TBI in a car accident or another incident, you should promptly seek medical care to obtain a proper diagnosis and appropriate treatment. With early treatment and rehabilitative care, recovering from a severe TBI might not lead to a full return to the patient’s former functioning level, but they can regain more independence and enjoy a better quality of life.
Ellen Diamond, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.
