Neurobehavioral Analysis and Treatment Planning following Traumatic Brain Injury
The reader has seen in the ﬁrst seven chapters of this text a systematic development of the medical dataset through which information is collected in order to proceed with the neurobehavioral analysis. Neurobehavioral analysis is a term of art describing the analytical procedures used by the neuropsychiatric examiner to summarize an examination of a patient in order to provide effective treatment planning and assistance. It is suggested that the components of the neurobehavioral analysis include all items developed in the ﬁrst seven chapters of this text, unless they have been adequately performed by other qualiﬁed persons, and that data are available to the neuropsychiatric examiners at the time they assess the patients following traumatic brain injury (TBI). For instance, the dataset for neurobehavioral analysis should in most cases include (1) a complete neuropsychiatric history, (2) a neuropsychiatric mental status examination, (3) a neurological examination, (4) neuroimaging, (5) a standardized neurocognitive assessment, (6) a standardized behavioral assessment, and (7) a review of the ambulance report, police records, emergency department records, hospital records, rehabilitation records, and outpatient treatment records that were developed at the time of the accident and thereafter. This chapter will focus upon the analysis of these various elements as they comprise the dataset following the examination. The schema described in Chapter 8 is neither exhaustive nor required, and it depends upon the particular medical orientation of the examiners as to how they wish to use these suggestions. For instance, a physiatrist may take an approach different than a neuropsychiatrist, and those approaches in turn will probably be different from that of a neurologist. Obviously, a neuropsychologist will have an approach different from that of most medical professions. That is not to say that one is better than the other, but it is still suggested that the seven elements above be included in the assessment. If they are not developed by the examiner at the time of his or her examination, the data should be sought from other sources to supplant the examiner’s analysis.