The 3 Must-Haves for Brain Injury Assessment

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 againat 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.


  1. Is testing covered by Medicare at Amen Clinic?

    Comment by Marilyn — January 20, 2020 @ 3:22 AM

  2. I have had 4 syncope episodes on the last 10 years. 3 of them resulted in head injuries because I fall straight back into my head. I may be dealing with epilepsy because no other diagnosis can be found. I’m 61 now & dealing with major depressive disorder. I’ve seen several mental health professionals who never asked the questions & never have I done any cognitive testing.

    Comment by Marguerite — January 20, 2020 @ 3:30 AM

  3. Has your organization ever reached out to NFL player Antonio Brown to offer your services? He seemed to have been a respectable person until the 2017 season when, during a game, he was tackled and received a devastating blow to his head. His behavior became erratic subsequent to that season. Can’t help but think it’s related.

    Comment by Dave Huskey — January 20, 2020 @ 6:12 AM

  4. Hello,
    Thank you for this incredible information. I am TBI survivor of 15 years and it has been a long journey and as your article states my mental health changed from being a stable happy , loving and successful women with a successful career, mother and wife to a person that was waiting to heal from my injury thinking I would recover and once be the women before TBI … Still to this day I have many challenges , confused memory, anxiety, posttraumatic stress syndrome, panic attacks, headaches on a daily basis, Sensitivity to light and sound as well as smells.

    With those challenges I was no longer I was no longer capable of continuing in My career, and my marriage of 31 years ended . You are right people have less compassion for people with a brain injury because he cannot see it and have a hard time understanding it.

    I am doing well now after all the destruction, I have learned to except my challenges and I’m just so thankful that there are people out there like you giving people knowledge because it took me a long time and most of it was self education and communication with my doctor.

    To all the people out there with a TBI who do you know it or do not know it you are not alone. It is my hope with research and technology on time our quality of life will continue to grow.

    Comment by Jan — January 20, 2020 @ 6:16 AM

  5. How can you tell if the concussions that I had throughout the years has anything to do with my nervous system.?

    Comment by Kimberly Lewis — January 20, 2020 @ 6:30 AM

  6. I have suffered 6 head injuries.3 resulting in a concussion or blacking out in my lifetime. I am now 62. What can i expcect as I age.

    Comment by Carol Strawn — January 20, 2020 @ 7:51 AM

  7. I had fallen down 35 years ago, I hit my head in the back (hypothalamus area). I passed out for minutes and I woke up again). Another a sharp pain in my neck.
    Problem in nowdays ????

    Comment by Maria Capizzani — January 20, 2020 @ 7:53 AM

  8. marguerite;
    First, if you suspect epilepsy, there is no shame in that. Your issue, if epilepsy related; is so treatable and controllable through prescription medication. Find a reputable neurologist who is younger than you — Two of my neurologists have retired due to their age. You want one who will be there for you and know your history. I too have never received cognitive testing, but somehow, our brains seem to signal “ I need you to strengthen this” or “challenge yourself this way” Hence my Fine Artist, College Professor, Football, weight- lifting and Army Officer skills development. You can do and be the person you want to be if you receive and find a great neurologist to help control your symptoms and episodes. Dont accept anything less than you require. I wish you all the best!

    Comment by Carlos — January 20, 2020 @ 10:03 AM

  9. Can a brain tumour at early age cause problems similar to brain injury late on in life?

    Comment by Elisa M — January 20, 2020 @ 3:04 PM

  10. That would probably depend upon which Medicare supplement you have. Medicare itself is pretty bare bones, with anything elsoe sometimes being available thru the supplement you have. An example of this is gym membership. Some medicare supplements include basic fitness club memberships (which to me makes sense). I suggest you call the clinic and ask.

    Comment by Arnie — January 23, 2020 @ 8:12 PM

  11. Maybe not that specific football player. I do seem to recall that Amen clinics have worked with former football players. I am a fan of informative YouTube videos. I may well have seen it there.

    Comment by Arnie — January 23, 2020 @ 8:17 PM

  12. My Significant Other had a stroke recently. He has recovered without significant physical deficits. However, we discovered he had what they called a rather large”silent stroke” sometime in the past which explains the behavior and cognizant changes that have seemed significant. Is it possible to reverse the brain changes due to a stroke? Even after some time has passed?

    Comment by Vicki C — January 30, 2020 @ 11:38 PM

  13. While playing football the other day, my nephew suffered from minor concussions which really worries me. I believe you did the right thing by saying that it's considerably fundamental to undergo magnetic and computerized scans when trying to determine the severity of our brain injury. Never mind, I'm gonna make sure a specialist looks after him and gives proper treatment to him.

    Comment by Amy Saunders — November 14, 2022 @ 6:15 AM

RSS feed for comments on this post.

Leave a comment

Contact Us