CLINICAL NEUROPSYCHOLOGICAL ASSESSMENT OF HEAD INJURY CASES - THE NEUROPSYCHOLOGICAL INTERVIEW
Schlesinger, R., Private Practice, Australia
The expert clinical neuropsychological evaluation has a unique role to play in the head injury litigation process. Though the clinical neuropsychologist is but one among many experts who can contribute to the evaluation of damages from traumatic head injury, the specialisation of the neuropsychologist in thoroughly evaluating the overall 'higher' brain functions sets this expert apart from the others. In most traumatic head injury cases, it is the impairment of such higher cerebral processes as attention, concentration, memory, language processes, complex thinking, emotional expression, and personality structure that constitute the bulk of the actual damages resulting from the injury. Though physicians such as physiatrists, neurologist, and psychiatrists can evaluate medical and physical deficits in details, their examinations of complex higher cerebral processes are relatively cursory and brief - sometimes lasting only a few minutes or so. In most head injury cases, this short assessment of higher cerebral functions is not adequate for a comprehensive evaluation of the deficits that must be interpreted as problems in activities of daily living and psychosocial adjustments. The neuropsychologists will measure the same higher functions as the above physicians but much more extensively and in minute detail over six to ten hours with tests that are normed, standardised, and comprehensive in scope. However, before administering specific neuropsychology tests, it is essential to formulate hypotheses by the means of a Structured Neuropsychological Interview which may reveal such symptoms that may not be inferred from the other administered tests, ie elementary hallucinations, olfactory hallucinations, incontinence and others. Such symptoms may then support the pathology that the other psychology tests may reveal or add other dimensions.