ABSTRACT
Whereas an understanding of the pathophysiology (Chapter One) and awareness of clinical presentation (Chapter Two) of traumatic brain injury are both essential, ultimately, in everyday clinical practice, it is the process of evaluating patients that constitutes the first step in rehabilitation. A thorough initial assessment of patients with traumatic brain injury is essential on all occasions. But this is not always a straightforward process. Patients tend to present with symptoms in different domains, which can make it difficult for the clinician to make sense of their symptoms and associated difficulties. Furthermore, some symptoms may be rather subtle in nature. And some of the symptoms, for example, poor attention, memory, and fatigue, may make it difficult for patients to persevere with the assessment process or, indeed, other interactions with healthcare professionals (Ashman, Gordon, Cantor, & Hibbard, 2006). Making an accurate assessment of patients’ neuro-behavioural symptoms is important for a few reasons, perhaps the main reason being that assessment has obvious implications for the management of the patient (46 McAllister, 2008). To ensure optimal management of patients, assessment of the brain-injured person should cover several important areas. For example, as Lishman (1998) pointed out, clinical assessment can be time-consuming and, ideally, needs to cover a physical examination, history taking, mental status examination, and psychological assessment.
