I, the Case: Experiences with Neurological Sequelae and Testing
Introduction: This paper is based on an autobiographical case of neuropsychological sequelae, neuropsychological tests, and outcomes following an MVA in 1993. It compares tests performed, physician beliefs, and medical practice encountered against professional literature development.
Background: During my crash, my head struck the struck the inside doorframe top. My spine compressed and twisted against the roof.
GCS and GOS were 10-12. I experienced a variety of neuropsychological sequelae consistent with moderate TBI, post-concussive syndrome, and PTSD. However, medical staff relayed divergent beliefs about tests, effectiveness of treatments, and the nature of TBI that was often contradictory and resulted in non-linear treatment pathway.
Method: I performed a literature search using InfoTrac and MedPub to locate refereed journal articles containing "neuropsychological evaluations," "neuropsychological sequelae," or "neuropsychological tests," and TBI. Resultant articles were arranged chronologically and topics, thematically, against tests, treatments and events in order to explore possible relationships between experience and literature.
Results: From 1980-1995, journal articles on malingering, preparing head injury cases for trial as either plaintiff or defendant, or the prospects of long-term improvement within mild to moderate TBI patients predominated. Literature focus shifted towards severity of injury in school-aged children, and then to the use of neuropsychological testing to guide medical treatment to improve quality of life in TBI survivors. Articles on adult patients often dealt with returning to work. My episodes with tests, diagnoses, and treatments reflect the non-linear development of the literature and field. Their divergence also support a comprehensive, multi-disciplinarian approach to brain injury rehabilitation.