The 3 Must-Haves for Brain Injury Assessment
By Kabran Chapek, ND
Head trauma can lead to psychiatric symptoms that steal your happiness and ruin your life. But how can you know if your “mental health” problems are related to a traumatic brain injury (TBI), even one that happened years or decades earlier?
In my book, Concussion Rescue, I outline all of the critical components of an adequate concussion assessment, but here are 3 of the most important you need to know about.
1. Investigate your history.
Have you ever fallen down a flight of stairs, hit your head in a car accident, or smacked your head while playing sports?
These are questions your physician should ask you, but unfortunately, most primary care physicians, psychiatrists, and counselors don’t think about underlying brain trauma as a possible cause for mental health symptoms.
With my patients at Amen Clinics, I ask a lot of questions about possible head injuries, and I typically ask them over and over again—at least 10 times! Some patients wonder why I keep repeating the same questions. Here’s why.
Many people experience amnesia surrounding a head injury. I have met with so many patients who answer “no” to all these questions multiple times before finally recalling falling off a horse or getting whiplash. In some cases, it’s another family member who has to jog their memory about a childhood accident
Also, as a society, we tend to minimize hits to the head and damage to the brain because we can’t see the injury. A person on the street with a broken leg hobbling on crutches will typically get more sympathy than someone with a brain injury.
In addition, many of my patients feel their injury simply wasn’t significant enough to mention. If they didn’t blackout or get diagnosed with a concussion, they think it isn’t worth bringing up. My advice is to bring up any and all incidents, no matter how insignificant you think they might be.
2. Test your cognitive functioning.
Cognitive testing, which involves any kind of examination that measures how your brain works, is another critical part of identifying brain trauma. For example, your doctor might ask you to remember 3 random words—such as purple, gravy, and Chevrolet—and then ask you to recite them 5 minutes later. This type of test measures recall memory, which is often impaired following a concussion or other type of TBI.
A cognitive exam typically involves testing the following functions:
- working memory
- processing speed
- attention
- verbal memory
- visuo-spatial recall
- reaction time
- executive function
Testing may involve using a standard pencil and paper, or it may be computerized. One such exam is WebNeuro, a generalized web-based test used to measure cognitive function. This test, which has been well-validated by the medical community for assessing many areas of brain function, takes about 30 to 45 minutes to complete and covers attention, processing speed, memory, mood, emotion identification, and self-regulation.
If you want to test your own cognitive function, you can do so by signing up to take WebNeuro on MyBrainFitLife. Your results are summarized so you can learn the areas of your cognitive function that are working well and areas that need to be optimized. You can also repeat the test to track your progress as you recover from a TBI.
3. Look at how your brain functions.
MRI (magnetic resonance imaging) or CT (computerized tomography) scans are normally used in brain injury assessment. In some cases, however, an MRI or CT scan will come back normal, even though a person has a brain injury. This is because MRIs and CTs look at the brain’s structure rather than function. It’s like taking a picture of a beautiful sports car that is pristine on the outside, but when you pop open the hood, the engine is a mess. Therefore, this perfect-looking car either won’t start or won’t run at optimum performance. It can be the same with an injured brain.
Functional brain imaging, such as SPECT (single photon emission computed tomography) is different. It can look “under the hood” of your brain rather than just at its structure. In other words, a SPECT scan looks at the activity of the brain and the brain’s blood flow. SPECT scans can show evidence of brain trauma, even if it’s from an accident that occurred decades earlier.
With this information, your physician can create the most effective treatment plan for you.
If you suspect you may have had a head injury that’s contributing to your mental health problems be sure to visit a physician who uses all 3 of these assessment methods, or your underlying injury could be missed. And remember, ruling out a TBI can be just as important in getting an accurate diagnosis.
In Concussion Rescue, author Dr. Kabran Chapek shares even more about the specific assessment methods, lab tests, and protocols he uses at Amen Clinics to help accurately diagnose patients with a TBI. Order your copy here.
If you or a loved one is struggling with symptoms that may be related to a concussion or TBI, understand that treating the underlying damage to the brain is the key to feeling better fast. At Amen Clinics, our Concussion Rescue Program has helped thousands of people heal from concussions and improve their quality of life. Speak to a specialist today at 888-288-9834 or schedule a visit online.
