Archives of Clinical Neuropsychology Advance Access first published online on March 17, 2009
This version published online on March 26, 2009
Archives of Clinical Neuropsychology, doi:10.1093/arclin/acp006
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Recommendations for Diagnosing a Mild Traumatic Brain Injury: A National Academy of Neuropsychology Education Paper
a San Francisco Clinical Neurosciences, San Francisco, CA, USA
b University of California–San Francisco, San Francisco, CA, USA
c University of British Columbia, Vancouver, BC, Canada
d British Columbia Mental Health and Addiction Services, Vancouver, BC, Canada
e University of Virginia School of Medicine, Charlottesville, VA, USA
f Long Island Neuropsychology, P.C., Lake Ronkonkoma, NY, USA
* Corresponding author at: 909 Hyde Street, Suite 620, San Francisco, CA 94109, USA. Tel.: +1-415-771-7833; fax: +1-415-922-5849. E-mail address: ronruff{at}mindspring.com (R.M. Ruff).
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Abstract |
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A special interest group of the American Congress of Rehabilitation Medicine [ACRM; Mild Traumatic Brain Injury Committee. (1993). Definition of mild traumatic brain injury. Journal of Head Trauma Rehabilitation, 8 (3), 86–87.] was the first organized interdisciplinary group to advocate four specific criteria for the diagnosis of a mild traumatic brain injury (TBI). More recently, the World Health Organization (WHO) Collaborative Center Task Force on Mild Traumatic Brain Injury [Carroll, L. J., Cassidy, J. D., Holm, L., Kraus, J., & Coronado, V. G. (2004). Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Journal of Rehabilitation Medicine, (Suppl. 43), 113–125.] conducted a comprehensive review of the definitions utilized in evidence-based studies with mild TBI patients. Based on this review, the WHO task force maintained the same four criteria but offered two modifications. The similarities and differences between these two definitions are discussed. The authors of the ACRM and the WHO definitions do not provide guidelines or specific recommendations for diagnosing the four criteria. Thus, we provide recommendations for assessing loss of consciousness, retrograde and post-traumatic amnesia, disorientation and confusion as well as clarification of the neurologic signs that can be indicative of a diagnosis of mild TBI. Finally, confounding factors mentioned in both definitions that should exclude a mild TBI diagnosis are summarized.
Keywords Mild traumatic brain injury; Neuropsychology; Treatment; Assessment; Head injury
Accepted: November 1, 2008
The Policy and Planning Committee of the National Academy of Neuropsychology (NAN) is charged with writing position and educational papers regarding important issues that affect the profession of Neuropsychology. Possible topics for the papers are suggested by the NAN Board of Directors, members of the NAN Policy and Planning Committee, or individual Academy members. Primary authors are identified and approved by the NAN Policy and Planning Committee. These authors can come from within or outside the Policy and Planning Committee. Selected outside reviewers provide extensive peer review for all papers. All topics and the final paper submissions are reviewed and approved by the NAN Board of Directors. This process of review and approval takes the place of the system of peer review typically conducted by the Editor and Editorial Board of this journal.