Traumatic Brain Injury, Concussion, Neuropsychological Assessments

Mild TRAUMATIC  BRAIN  INJURIES and Concussions Measured by Neuropsychological Assessments

Traumatic Brain Injuries and Concussions have been in the news a lot over the past few years, primarily in reference to sports injuries.  However, traumatic brain injuries can occur in situations not previously viewed as dangerous. Falling down, a car accident without directly hitting the head, or falling off a bicycle can cause cellular damage. It’s great that helmets are getting better at protecting skulls. They cannot, however, do much to protect the soft brain from scraping against the sharp bones that support it. An individual with a normal CT-scan can still demonstrate a change of behavior related to a traumatic brain injury because damage often occurs at the cellular level—too small for the CT-scan or MRI to show.

It is now widely accepted that less than 10% of concussions involve a loss of consciousness. If an individual does not lose consciousness and has a clear CT-scan or MRI, how can we tell when damage has been done?

Neuropsychology is the study of the relationship between behavior and brain function.  A neuropsychological assessment can determine if there has been significant damage, even if it does not show up on a brain scan.

Childhood injuries are complicated by the fact that some behaviors related to an injury (for example, an explosive temper) may appear to be normal. Also, because children’s brains are still developing, damage to an area associated with a particular ability (for example, math), won’t show up as being damaged until that child reaches the developmental stage when that math ability should appear.

A neuropsychological assessment is important for three reasons. 1) It can measure if there are significant differences within an individual child’s functioning; 2) it can compare the individual child’s cognitive profile to other children his or her age; and, 3) it can provide a baseline to compare future profiles against if there is a future injury. This allows doctors to see how much and what type of damage was done. An added bonus of a neuropsychological assessment for children is that it can indicate how a child learns best so it will be easier to facilitate success in school.

My child has never lost consciousness. Should I be concerned about Mild Traumatic Brain Injury (mTBI)?

If your child has fallen and/or hit his head (especially if there was a lump involved), gotten stitches in her head, or been in a car accident where there was a significant impact even without apparent injuries, watch for these symptoms:

-memory deficits,

-reduced ability to plan and follow through,


-impaired awareness of time,

-problems with math and spelling but not necessarily reading,


-lack of initiative


-impairment of spatial perception,

-word retrieval problems, and

-explosive temper outbursts (often with little provocation or escalation)

What should I do?

If you see these symptoms in your child, you may want to consider getting a neuropsychological evaluation.