Brain Injury
Oral Presentation
Mary Russell, DO, MS
Assistant Professor
University of Texas McGovern Medical School at Houston
The Woodlands, Texas
Heather Smith, MA, CCC-SLP
Clinical Coordinator - Speech-Language Pathology
TIRR Memorial Hermann - The Woodlands
Jersey Village, Texas
Mild Traumatic Brain Injury accounts for nearly 75% of all brain injuries. It is commonly underdiagnosed. Even among those with years of experience, it can present a challenge. The current diagnostic criteria are highly limited, variable, and based upon subjective self-report. The subjective nature of the symptoms, both in quantity and quality, together with their large overlap in other physical and behavioral maladies, limit the clinician's ability to accurately diagnose, treat and make prognostic decisions in such injuries. (Cook et al, 2014) In this presentation, the audience will be exposed to the following objectives:
1. Identifying and diagnosing mTBI: what are the complex combination of cognitive, physical, emotional and social sequelae. What are the current diagnostic criteria? In the past 5-10 years, there has been changing and evolving diagnostic definitions which make the classification of mTBI more complicated than ever.
2. List challenges in treating mTBI.
a. This population is one in which the level of difficulty reported often relates to very high-level cognitive, linguistic, motoric and pragmatic function. It is a population that represents a rapid, expanding, and transforming subset of overall clinical caseload and one in which attempts to measure recovery outcome must increasingly focus on a wide array of social, economic, academic and employment criteria.
b. There are also obstacles to service for this population. Underdiagnosing and providing information given to patients and family members in ED or acute care settings can be an impediment to treatment.
c. Many speech-language pathologists are using aphasia batteries to assess individuals with mTBI despite the substantial qualitative differences between the linguistic domains targeted with these tools and the primary cognitive and cognitive-communicative deficits characteristic of mTBI (Duff et al, 2002).
3. Solutions for overcoming challenges in mTBI. There is increasing focus on assessing the service needs and outcomes of post-TBI rehabilitation.
a. Solutions can include assessment of commonly used instruments and can they detect subtle deficits or do these need to be developed.
b. Increasing awareness of mTBI and criteria among providers and public.
c. Need for further research and information on non-traditional treatment procedures and protocols for individuals with mTBI and investigations to determine efficacy of treatment.
d. Improved overall care we provide to the entire TBI population with education and training regarding the management of individuals with TBI and the counseling of patients and their family members.