chapter  4
50 Pages

The Neuropsychiatric Mental Status and Neurological Examinations following Traumatic Brain Injury

Once the neuropsychiatric interview and history taking are complete, the examiner moves to the core components of a neuropsychiatric assessment of any kind, including traumatic brain injury (TBI). The two principal sources of information on which a neuropsychiatric and neurobehavioral diagnosis is based are the neuropsychiatric history and the neuropsychiatric mental status and neurological examinations. This chapter describes first the detailed mental and neurological examinations of the adult patient and then follows that with a similar detailed explanation of these examinations in the child. The neuropsychiatric mental examination expands upon the classic mental status examination taught within a psychiatric residency and during medical school training. This examination was initially based upon mental examination techniques Adolf Meyer first proposed almost 100 years ago at Johns Hopkins University. However, moving from the more classic examination of mental status to a neuropsychiatric mental status examination requires the examiner to focus upon a brain-based examination rather than the more traditional emotional and mind-based examination. Those wishing to follow the more classical and updated mental status examination of modern psychiatry can consult Trzepacz and Baker.1 If the examiner wishes a more neurological approach to the mental status examination, the text by Strub and Black is recommended.2 For those examiners practicing neuropsychology, the techniques of Lezak3 are recommended. To make the mental examination even more cerebral based, the recent text by Cummings and Mega is highly recommended.4