Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment

by Michael A. McCrea

Overview

This is the first neuropsychology book to translate exciting findings from the recent explosion of research on sport-related concussion to the broader context of mild traumatic brain injury (MTBI) and post-concussive syndrome (PCS) in the general population. In addition, it includes a Continuing Education (CE) component administered by the American Academy of Clinical Neuropsychology.

Traumatic brain injuries constitute a major global public health problem, but until now, MTBIs, which constitute up to 90 percent of all treated TBIs, have been difficult to evaluate and manage clinically because of the absence of a viable model. Dr. McCrea's book thus provides a welcome evidence base for all clinicians - including psychologists, neuropsychologists, neurologists, neurosurgeons, rehabilitation medicine physicians, physiatrists, and nurses - involved in the clinical diagnosis and treatment of MTBI, as well as attorneys involved in personal injury litigation and personal injury defense. Each section of the book ends with a helpful summary of the 'Top 10 Conclusions.' Instructions for earning AACN-administered CE credit are included.

Product Details

ISBN-13:	9780195328295
Publisher:	Oxford University Press, USA
Publication date:	08/08/2007
Series:	AACN Workshop Series
Edition description:	New Edition
Pages:	224
Product dimensions:	9.10(w) x 6.10(h) x 0.60(d)

About the Author

Dr. McCrea is Executive Director of the ProHealth Care Neuroscience Center in Milwaukee, Wisconsin. He is a board-certified clinical neuropsychologist and has been head of the Neuropsychology Service at Waukesha Memorial Hospital since 1996. He is also Associate Adjunct Professor of Neurology, Medical College of Wisconsin, Milwaukee and Adjunct Clinical Associate Professor, Department of Psychology, University of Wisconsin-Milwaukee. Dr. McCrea has been an active research in the neurosciences, with numerous scientific publications, book chapters, and national and international lectures on the topic of traumatic brain injury.

Table of Contents

Introduction     ix
Continuing Education (CE) Credit     xiii
Author's Workshop Materials     xiii
Acknowledgments     xv
The TBI Landscape     1
Epidemiology and Impact of Traumatic Brain Injury     3
Zeroing In on MTBI: Epidemiology and Impact     7
Challenges in Defining and Diagnosing MTBI     13
Advances in MTBI Research Methodologies     29
Top 10 Conclusions     37
References     39
Basic and Clinical Science of MTBI     43
Biomechanics of MTBI     45
Neurophysiology of MTBI: The Neurometabolic Cascade     53
Neuroimaging in MTBI     61
Top 10 Conclusions     71
References     73
The Natural History of MTBI     83
Acute Symptoms and Symptom Recovery     85
Acute Cognitive Effects and Early Recovery     97
Neuropsychological Recovery     109
Influence of Acute Injury Characteristics on Recovery     119
Measuring Neurophysiologic Recovery     125
Functional Outcome After MTBI     129
Exceptions to the Rule: Potential Long-Term Effects of MTBI     133
Top 10 Conclusions     138
References     140
Implications for Rethinking Postconcussion Syndrome     151
Defining Postconcussion Syndrome     153
Nonspecificity of Postconcussion Syndrome Symptoms     159
Epidemiology of Postconcussion Syndrome: Another Denominator Problem     163
PCS as a Neuropsychological Disorder     169
Psychological Theories of Postconcussion Syndrome     173
Interventional Models for Postconcussion Syndrome     177
A Practical Model for Clinical Management of PCS     181
Top 10 Conclusions     188
References     189
Final Summary and Conclusions     195
Index     197
About the Author     205

Editorial Reviews

Reviewer: Christopher J Graver, PhD, ABPP-CN(Madigan Healthcare System)
Description: Mild traumatic brain injuries have been receiving increasing attention with the return of Iraqi war veterans who suffered blast concussions and NFL football players who have come forward with reports of detrimental outcomes after multiple concussions. While neuropsychology has been at the forefront of traumatic brain injury research for decades, the science has not been widely disseminated among other healthcare professionals. Thus, this book is focused on disseminating current findings on mild traumatic brain injury and postconcussion syndrome.
Purpose: One of the most fundamental unanswered questions of mild traumatic brain injury is that of its natural course. This book aims to present the most current research on mild traumatic brain injury to describe both the symptoms and course of such an injury.
Audience: The book is intended for neuropsychologists, neurologists, neurosurgeons, and other healthcare professionals who evaluate and care for brain injured individuals. The author has an extensive research history on this topic and is a leading authority on mild traumatic brain injury.
Features: An introductory chapter discusses traumatic brain injuries of all severity levels and then focuses more specifically on mild traumatic brain injury. The third chapter contains a useful discussion of defining and differentiating brain injury severity. The advantages of the methodology used by the editor in his sports injury research are outlined and could be generalized to other populations. The chapters in section two are focused on the biomechanics of mild traumatic brain injury, as well as neurophysiology and neuroradiology. The third section addresses the course, cognitive findings, and recovery of mild traumatic brain injury. Finally, the last section emphasizes a new way of thinking about postconcussion syndrome. Each chapter is well organized and the information is easy to access through clear subsections and summary tables/illustrations. The major sections also end with a summary of key points from the preceding chapters, which facilitates comprehension of the material. The references are excellent and often very current. The index, however, has some significant gaps, making it difficult to quickly reference particular topics of interest. As an added bonus, continuing education credits can be earned in conjunction with this book.
Assessment: The editor has gathered together many of the best and most current peer-reviewed publications on mild traumatic brain injury and compiled an excellent reference. Any well informed healthcare provider will want to pick up a copy of this book. Furthermore, it should appeal to busy professionals in its concise presentation.

Doody's Review Service

"The editor has gathered together many of the best and most current peer-reviewed publications on mild traumatic brain injury and compiled an excellent reference. Any well informed healthcare provider will want to pick up a copy of this book."—Doody's, a 5-star review!

"This is a very good book that describes the neurological and neuronal reasons why some clients with MTBI and PCS do not make the progress that would be expected...It provides great information about methods that can be used to understand the patient's level of consciousness, treatment integrity, and how a team approach can be utilized."—Archives of Clinical Neuropsychology

"[This book] is a jewel. It is rare in its accomplishment to so succinctly cover such an impressive amount of research...Old hands and students alike will find this book a concise and comprehensive reference text on the topic of MTBI and PCS...I wholeheartedly recommend this book to all with an interest or need."—Ty S. Callahan, Journal of the International Neuropsychological Society

From the Publisher