Skip to main content
SpringerLink
Log in

Traumatic Brain Injury Rehabilitation Case Study

  • Chapter
  • First Online:
Physician's Field Guide to Neuropsychology

Abstract

TBI rehabilitation case is a case example of traumatic brain injury (TBI) using neuropsychological (NP) and neurological evaluations and follow-ups to assist the patient in helping her reach her long-term rehabilitation goals. The largest obstacles to achieving success included the patient’s defensiveness and psychological reactions to her situation, fatigue, and higher-level cognitive challenges which were detected on neuropsychological assessment.

Key Questions

  1. 1.

    What are the benefits of conducting a neuropsychological examination, and how can this data be used to help the physiatrist manage the overall care?

  2. 2.

    How can the neuropsychologist and physiatrist collaborate effectively to help the patient reach her neurorehabilitation goals?

This case study helps to demonstrate the value of NP testing in treatment of TBI, as well as the value of establishing a strong collaborative relationship between the neuropsychologist and the physiatrist specializing in brain injury rehabilitation.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Lezak MD, Howieson DB, Bigler ED, Tranel D. Neuropsychological assessment. New York: Oxford University Press; 2012.

    Google Scholar 

  2. Brooks N, McKinlay W, Symington C, Beattie A, Campsie L. Return to work within the first seven years of severe head injury. Brain Injury. 1987;1(1):5–19.

    Article  CAS  Google Scholar 

  3. Thomsen IV. Late outcome of very severe blunt head truma: a 10–15 year second follow-up. J Neurol Neurosurg Psychiatry. 1984;47:260–8.

    Article  CAS  Google Scholar 

  4. Kolakowsky-Hayner SA, Miner KD, Kreutzer JS. Long-term life quality and family needs after traumatic brain injury. J Head Trauma Rehabil. 2001;16(4):374–85.

    Article  CAS  Google Scholar 

  5. Ponsford JL, Olver JH, Curran C, Ng K. Prediction of employment status 2 years after traumatic brain injury. Brain Injury. 1995;9(1):11–20.

    Article  CAS  Google Scholar 

  6. Borgaro SR, Baker J, Wethe JV, et al. Subjective reports of fatigue during early recovery from traumatic brain injury. J Head Trauma Rehabil. 2005;20:416–25.

    Article  Google Scholar 

  7. Cantor JB, Bushnik T, Cicerone K, Dijkers MP, Gordon W, Hammond FM, Kolakowsky-Hayner SA, Lequerica A, Nguyen M, Spielman LA. Insomnia, fatigue, and sleepiness in the first 2 years after traumatic brain injury: a NIDRR TBI model system module study. J Head Trauma Rehabil. 2012;27(6):E1–14.

    Article  Google Scholar 

  8. Lucas S, Hoffman JM, Bell KR, Dikmen S. A prospective study of prevalence and characterization of headache following mild traumatic brain injury. Cephalalgia. 2014;34(2):93–102.

    Article  Google Scholar 

  9. Godbolt AK, Stenberg M, Jakobsson J, Kimmo S, Krakau K, Stalnacke FM, DeBoussard CN. Subacute complications during recovery from severe traumatic brain injury: frequency and associations with outcome. BMJ Open. 2015;5(4):e007208.

    Article  Google Scholar 

  10. Barnett BP, Singman EL. Vision concerns after mild traumatic brain injury. Curr Treat Options Neurol. 2015;17(2):329.

    Article  Google Scholar 

  11. Gardani M, Morfiri E, Thomson A, O-Neill B, McMillan T. Evaluation of sleep disorders in patients with severe traumatic brain injury during rehabilitation. Arch Phys Med Rehabil. 2015;15:418–9.

    Google Scholar 

  12. Ponsford JL, Sinclair KL. Sleep and fatigue following traumatic brain injury. Psychiatr Clin North Am. 2014;37(1):77–89.

    Article  Google Scholar 

  13. Seel RT, Kreutzer JS, Rosenthal M, Hammond FM, Corrigan JD, Black K. Depression after traumatic brain injury: a national institute on disability and rehabilitation research model systems multicenter investigation. Arch Phys Med Rehabil. 2003;84:177–84.

    Article  Google Scholar 

  14. Deb S, Lyons I, Koutzoukis C, Ali I, McCarthy G. Rate of psychiatric Illness 1 year after traumatic brain injury. Am J Psychiatry. 1999;156:374–8.

    CAS  PubMed  Google Scholar 

  15. Kreutzer JS, Seel RT, Gourley E. The prevalence and symptom rates of depression after traumatic brain injury: a comprehensive examination. Brain Injury. 2005;15(7):563–76.

    Article  Google Scholar 

  16. Varney NR, Martzke JS, Roberts RJ. Major depression in patients with closed head injury. Neuropsychology. 1987;1(1):7–9.

    Google Scholar 

  17. Lezak M. Relationship between personality disorders, social disturbances, and physical disability following traumatic brain injury. J Head Trauma Rehabil. 1987;2(1):57–69.

    Article  Google Scholar 

  18. Dickmen SS, Bombardier CH, Machamer JE, Fann JR, Temkin NR. Natural history of depression in traumatic brain injury. Arch Phys Med Rehabil. 2004;85(9):1457–64.

    Article  Google Scholar 

  19. Jorge RE, Robinson RG, Arndt SV, Starkstein SE, Forester AW, Geisler F. Depression following traumatic brain injury: a 1 year longitudinal study. J Affect Disord. 1993;27(4):233–43.

    Article  CAS  Google Scholar 

  20. MacNiven E, Finlayson MA. The interplay between emotional and cognitive recovery after closed head injury. Brain Injury. 1993;7:241–6.

    Article  CAS  Google Scholar 

  21. Malec JF, Moessner AM. Self-awareness, distress, and post-acute rehabilitation outcome. Rehabil Psychol. 2000;45:227–41.

    Article  Google Scholar 

  22. Rosenthal M, Christensen BK, Ross TP. Depression following traumatic brain injury. Arch Phys Med Rehabil. 1998;79:90–103.

    Article  CAS  Google Scholar 

  23. Cantor JB, Ashman TA, Schwartz ME, Gordon WA, Hibbard MR, Brown M, Spielman L, Charatz HJ, Cheng Z. The role of self-discrepancy theory in understanding post-traumatic brain injury affective disorders: a pilot study. J Head Trauma Rehabil. 2005;20(6):527–43.

    Article  Google Scholar 

  24. Lam B, Middleton LE, Masellis M, Stuss DT, Harry RD, Kiss A, Black SE. Criterion and convergent validity of the Montreal cognitive assessment with screening and standardized neuropsychological testing. J Am Geriatr Soc. 2013;61(12):2181–5.

    Article  Google Scholar 

  25. Pendlebury ST, Markwick A, deJager CA, Zombini G, Wilcock GK, Rothwell PM. Differences in cognitive profile between TIA, stroke and elderly memory research subjects: a comparison of the MMSE and MoCA. Cerebrovasc Dis. 2012;34(1):48–54.

    Article  CAS  Google Scholar 

  26. Breceda EY, Dromerick AW. Motor rehabilitation in stroke and traumatic brain injury: stimulating and intense. Curr Opin Neurol. 2013;26(6):595–601.

    Article  Google Scholar 

  27. Trexler L, Webb PM, Zappala G. In: Christensen AL, Uzzell Barbara P, editors. Strategic aspects of neuropsychological rehabilitation. As seen in brain injury and neuropsychological rehabilitation: international perspectives. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers; 1994.

    Google Scholar 

  28. Galski T, Ehle HT, McDonald MA, Mackevich J. Evaluating fitness to drive after cerebral injury: basic issues and recommendations for medical and legal communities. J Head Trauma Rehabil. 2000;15:895–908.

    Article  CAS  Google Scholar 

  29. Dawson JD, Uc EY, Anderson SW, et al. Neuropsychological predictors of driving errors in older adults. J Am Geriatr Soc. 2009;58:1090–6.

    Article  Google Scholar 

  30. Sigurdardottir S, Andelic N, Roe C, Schanke AK. Cognitive recovery and predictors of functional outcome 1 year after traumatic brain injury. J Int Neuropsychol Soc. 2009;33:202–10.

    Google Scholar 

  31. Wilde EA, Whiteneck GG, Bogner J, Bushnik T, Cifu DX, Dikmen S, French L, Giacino JT, Hart T, Malec JF, Millis SR, Novack TA, Sherer M, Tulsky DS, Vanderploeg RD, von Steinbuechel N. Recommendations for the use of common outcome measures in traumatic brain injury research. Arch Phys Med Rehabil. 2010;91:1650–60.

    Article  Google Scholar 

  32. Vanderploeg RD, Collins RC, Sigford B, Date E, Schwab K, Warden D. Practical and theoretical considerations in designing rehabilitation trials: the DVBIC cognitive-didactic versus functional-experiential treatment study experience. J Head Trauma Rehabil. 2006;21:179–93.

    Article  Google Scholar 

  33. Christensen AL, Uzzell BP. International handbook of neuropsychological rehabilitation. New York: Kluwer Academic/Plenum Press; 2000.

    Book  Google Scholar 

  34. Parker RS. Traumatic Brain Injury and Neuropsychological Impairment: sensorimotor, cognitive, emotional, and adaptive problems of children and adults. New York: Springer-Verlag; 1990.

    Book  Google Scholar 

  35. Mitrushina MN, Boone KB, D’Elia LF. Handbook of normative data for neuropsychological assessment. New York: Oxford University Press; 1999.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Rehabilitation Hospital of Indiana—Indiana University, Indianapolis, IN, USA

    Samantha L. Backhaus

  2. Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN, USA

    Ana Durand-Sanchez

Authors
  1. Samantha L. Backhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ana Durand-Sanchez
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Samantha L. Backhaus .

Editor information

Editors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA

    Karen M. Sanders

Chapter Review Questions

Chapter Review Questions

  1. 1.

    In this case, the diagnosis of TBI was already known. Given this information, how was it useful to obtain neuropsychological testing data, and how did this guide the treatment recommendations for the patient’s outpatient treatment, particularly given that she appeared so “high-level” and obtained some “average” scores?

  2. 2.

    Why was it important to recommend that a more comprehensive neuropsychological test be given as opposed to providing a basic mental status examination for this patient? Are there times when administering mental status examinations can be useful?

  3. 3.

    Why was it important for the physiatrist to have some knowledge on treatment of mood disturbances, and when would it have been a good idea to refer out to a psychiatrist?

  4. 4.

    How does collaboration with a neuropsychologist help a physician better monitor a patient’s cognitive progress and rehabilitation process? How does it help synergize the management of mood disturbances?

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Science+Business Media, LLC, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Backhaus, S.L., Durand-Sanchez, A. (2019). Traumatic Brain Injury Rehabilitation Case Study. In: Sanders, K. (eds) Physician's Field Guide to Neuropsychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-8722-1_26

Download citation

  • DOI: https://doi.org/10.1007/978-1-4939-8722-1_26

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-8720-7

  • Online ISBN: 978-1-4939-8722-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation