Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment,Third Edition, 3rd Edition (Hardback) book cover

Traumatic Brain Injury

Methods for Clinical and Forensic Neuropsychiatric Assessment,Third Edition, 3rd Edition

By Robert P. Granacher, Jr.

CRC Press

597 pages | 46 B/W Illus.

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Traumatic Brain Injury: Methods for Clinical and Forensic Neuropsychiatric Assessment, Third Edition provides physicians and psychologists with a scientifically based schema for the clinical evaluation of traumatic brain injury (TBI).

The book assists physicians and psychologists in developing treatment plans for patients who have sustained TBIs and also guides those providing forensic analysis to lawyers, insurance bodies, workers’ compensation systems, triers of fact, and other stakeholders in the adjudication of victims of TBI.

The procedures and recommendations in this book are grounded in highly referenced evidence-based science but also come from more than 5000 cases wherein the author and contributors have personally examined individuals who have sustained a TBI, or who claim to have sustained a TBI.

This edition has been entirely rewritten. The style now follows a more traditional neuropsychiatric format than previous editions. Since the last edition, there has been increased awareness and scientific study regarding the effects of blast brain injury as a consequence of US military experiences in Afghanistan and Iraq.

There is also increased interest in the phenomenology of mild traumatic brain injury and, in particular, the forensic complications associated with evaluations of this disorder. Chronic traumatic encephalopathy has also received significant scrutiny in the last decade, possibly associated with sports injuries.

This book is a comprehensive resource for clinicians treating patients as well as for forensic specialists. Its purpose remains the same as in prior editions—to provide physicians or psychologists with a practical method for an effective evaluation of TBI based upon known scientific principles of brain-behavior relationships and state-of-the-art clinical, neuroimaging, neuropsychological, and psychological techniques.

Table of Contents

Epidemiology and Pathophysiology of Traumatic Brain Injury


Epidemiology of Traumatic Brain Injury

Definitions of Traumatic Brain Injury

Classification of Traumatic Brain Injury


Blunt Force Head Injury

Penetrating Brain Injury

Military or Blast Brain Trauma

Sports Injuries

Concussion in Sports

Chronic Traumatic Encephalopathy

Pediatric Traumatic Brain Injury

Geriatric Traumatic Brain Injury

Molecular Biology and Pathophysiology of Traumatic Brain Injury

Primary Diffuse Brain Injury

Diffuse Axonal Injury

Primary Focal Brain Injury

Secondary Traumatic Brain Injury

Genetics and Brain Trauma

A Default Mode of Brain Function


Neuropsychiatric and Psychiatric Symptoms after Traumatic Brain Injury

Neuropsychiatric Syndromes in Adults

Adult Cognitive Disorders

Frontal Brain Syndromes of Impaired Executive Function

Attentional Impairment Following Pediatric TBI

Pediatric Neuropsychiatric Syndromes

Neuropsychiatric/Somatic Syndromes

Psychiatric Syndromes


Taking the Neuropsychiatric History after Traumatic Brain Injury


General Premorbid Neuropsychiatric History

Birth and Perinatal History

Developmental History

Handedness Laterality and Motor Skills

Seizures and "Spells"

Substance Use and Abuse

Premorbid Personality

Preinjury Cognitive Status

Aggressive Behaviors

Specific Neuropsychiatric TBI History

Attentional History after TBI

Memory History after TBI

Speech and Language History after TBI

Visuospatial History after TBI

Executive Function History after TBI

Affect and Mood History after TBI

Thought Processing History after TBI

Suicidal Ideation after TBI

Neurobehavioral Treatment History Following TBI

Activities of Daily Living History after TBI

Pre-TBI Medical History (Past Medical History)

Family History

Review of Systems after TBI

Child Brain Injury History

Preinjury Developmental History

Family History

Attentional History after TBI

Communication History after TBI

Memory History after TBI

Visuospatial History after TBI

Intellectual History after TBI

Executive Function History after TBI

Mood and Affective History after TBI

Academic History after TBI

Review of Records

Adult or Child Record Review

Child Record Review


Performing the Neuropsychiatric Mental Status and Neurological Examinations after Traumatic Brain Injury

Adult Mental Status Examination

Sensory Domain-Specific Recognition


Mood and Affect

Thought Processing

Thought Content and Perception

Insight and Self-Awareness

Judgment and Decision-Making Capacity

Risk to Self or Others

Adult Neurological Examination after TBI

Head and Neck Examination

Cranial Nerve Examination

Sensory Function Examination

Motor Impairment Examination

Motor Vehicle Driving after Traumatic Brain Injury

Child Mental Status Examination

Speech and Language

Memory and Orientation

Visuospatial and Constructional Ability

Executive Function

Affect and Mood

Thought Processing, Content, and Perception

Child Neurological Examination


Cranial Nerve Examination

Motor Examination

Gait Examination

Sensory Testing

Coordination Testing


Use of Neuroimaging in the Neuropsychiatric Assessment of Traumatic Brain Injury


Structural Imaging of Primary Brain Trauma

Functional Imaging of Brain Trauma

Positron Emission Tomography

Single Photon Emission Computed Tomography after TBI

Magnetic Resonance Spectroscopy after TBI

Functional Magnetic Resonance Imaging (fMRI) after TBI

Electroencephalography after TBI

Nonaccidental Trauma (Child Abuse)

Birth Trauma

Extracranial Birth Trauma

Skull Fractures in the Newborn

Traumatic intracranial Hemorrhage in the Newborn


Standardized Neurocognitive Assessment of Traumatic Brain Injury


Basic Concepts of Psychological Testing

Adult Neurocognitive Assessment

Comparison Standards for Deficit Measurement

Measurement of Neuropsychological Deficits

Deficit Measurement Paradigm

Practice Effects of Repeated Neuropsychological and Psychological Testing

Using Symptom Validity Tests (SVTs) and Performance Validity Tests (PVTs)

Measuring Attention

Measuring Memory

Measuring Language and Communication Disorders Following TBI


Verbal Expression

Verbal Comprehension

Verbal Academic Skills

Measuring Somatosensory and Motor Function

Measurement of Visuospatial Processing and Constructional Tasks

Measuring Executive Functions and Reasoning

Measuring General Ability

Measuring Pediatric Neurocognition after TBI

Measuring Symptom Validity and Response Bias in Children

Establishing a Preinjury Cognitive Baseline in Children

Measuring Attention in Children

Measuring Memory in Children

Measuring Language in Children

Measuring Visuoperceptual Ability in Children

Measuring Sensory Motor Function in Children

Measuring Executive Function in Children

Measuring General Ability in Children

Measuring Cognitive Injury in the Very Young Child


Behavioral Assessment Following Traumatic Brain Injury


Adult Behavioral Measurements

Child Behavioral Measurements


Neuropsychiatric Examination Database and Treatment Planning


Mental Status Examination

Neurological Examination

Brain Neuroimaging

Neuropsychological Measures

Psychological and Behavioral Measures

Impact of Brain Injury on Caregivers

Neuropsychiatric Treatment Planning Following TBI

Neuropsychopharmacological Management of Cognitive and Executive Disorders Following TBI

Neuropharmacologic Management of Behavioral Symptoms Following Traumatic Brain Injury

Assisting the Family after TBI

Neurobehavioral Analysis of Case Studies


Forensic Examinations of Traumatic Brain Injury: Distinctions from Examinations for Treatment


Critical Differences between Treatment Examinations and Forensic Assessment of Traumatic Brain Injury

Legal Rules Governing the Admissibility of Scientific Evidence at Court Mandated Reporting

Evaluating Civil Competence Following Traumatic Brain Injury

Testamentary Capacity and Vulnerability to Undue Influence

Contractual Capacity

Personal Injury


Aphasia and Dysphasia

Language Use Other than English


Dangerousness and Risk of Violence

Suicide Risk Assessment

Competency to Stand Trial

Criminal Responsibility and the Insanity Defense

Health-Care Decision Making and Informed Consent

Persistent Vegetative States

Do-Not-Resuscitate (DNR) Orders

Advance Directives


Causation, Damages, Impairments, Disability, Outcomes, and Forensics of TBI Examinations




Determining Impairment Following TBI

Disability Determination

Adult Outcomes of TBI

Child Outcomes In Traumatic Brain Injury

Forensics of Inflicted Child TBI (Child Abuse)

Forensics of Mild Traumatic Brain Injury

Forensics of Neuropsychiatric Neuroimaging in TBI

Forensics of Structural Neuroimaging after TBI

Forensics of Functional Neuroimaging after TBI inflicted Child TBI

Forensics of TBI Symptom Validity Determination

Basic Principles of Forensic Medical Report Writing


Neurobehavioral Analysis of Traumatic Brain Injury Forensic Data


Analysis and Collection of Acute Injury Data Following TBI

Police Record or Injury Report

Police Investigative File

Accident Scene Photographs

First Responder or Ambulance Reports

Emergency Department Records

Hospital Record

Rehabilitation Records

Neuropsychology/Psychology Records

Outpatient Treatment

Analysis of the Forensic TBI Examination Database

Using Collateral History Sources

Preinjury Medical Records

Academic and Employment Records

Legal Records

Military Records

Causation Analysis

Damages Analysis

Neurobehavioral Analysis of Forensic Case Studies


About the Author

Robert P. Granacher Jr., MD, MBA, is a clinical professor of psychiatry in the Department of Psychiatry at the University of Kentucky College of Medicine in Lexignton. He also practices privately as a treating neuropsychiatrist and as a forensic neuropsychiatrist. Dr. Granacher obtained his MD from the University of Kentucky, Lexington. He later served as a resident and fellow at Harvard University and the Massachusetts General Hospital and other Harvard University teaching hospitals in Boston. He specializes in the neuropsychiatric treatment and evaluation of traumatic brain injury, perinatal birth injury, toxic brain injury, and other complex neurobehavioral disorders. Dr. Granacher is a distinguished life fellow of the American Psychiatric Association and a member of the American Neuropsychiatric Association.

Subject Categories

BISAC Subject Codes/Headings:
LAW / Forensic Science
MEDICAL / Neurology
MEDICAL / Neuroscience
MEDICAL / Psychiatry / General