Assessing Concussion Recovery and Persisting Symptoms
For a significant minority, concussion symptoms last for months or even years, affecting careers, relationships, and overall wellbeing. Despite the common expectation of full recovery within weeks, persistent symptoms can complicate this process, leading to controversy and diverging opinions on the causes. This is where neuropsychological assessment plays a pivotal role.
As a neuropsychologist working in personal injury cases, I have the privilege of hearing many people’s stories following a concussion. Each recovery journey is as unique as the individual’s accident, brain, and life history prior to the injury. My role is to assess the broader impact of the concussion or mild TBI on the person’s life—emotionally, cognitively, and behaviourally—while understanding how these changes affect their ability to return to work, daily responsibilities, and recreational activities.
A comprehensive neuropsychological assessment typically includes three key components:
Reviewing the injury: Determining the likelihood that brain damage occurred based on the nature of the injury.
Conducting objective testing: Using reliable, evidence-based tools to assess cognitive impairment, emotional changes, and behaviour, while validating the results to ensure accuracy on the day of testing.
Understanding causality: The most complex aspect—unpacking the factors contributing to cognitive or emotional difficulties. This may include pre-existing learning difficulties, mental health conditions, or the influence of pain and psychological distress on the individual’s performance.
What makes neuropsychology, and concussion assessment in particular, fascinating is that it’s a constantly evolving field. New discoveries—such as advancements in neuroimaging techniques—continue to shed light on the brain’s recovery process, the development of persistent symptoms, and the most effective interventions. With each advancement, we refine our ability to offer more precise diagnoses and tailored rehabilitation strategies.
Teasing apart these different factors isn’t always straightforward. In many cases, a combination of influences is at play. Neuropsychological assessments help clarify these complexities, providing an evidence-based framework that guides both rehabilitation efforts and medico-legal decision-making.
If you are interested in finding out more about persisting symptoms following concussion, here’s an article written by an ABC journalist who experienced concussion herself. It outlines some of the current controversies, issues with treatment accessibility, research directions, and her own lived experience: ABC Concussion Article
For neuropsychologists and lawyers seeking a comprehensive overview of this topic, I recommend this excellent resource:
Moore, P. S., Brifcani, S., & Worthington, A. (Eds.). (2021). Neuropsychological Aspects of Brain Injury Litigation: A Medicolegal Handbook for Lawyers and Clinicians. Routledge.