Do I have brain damage? How a Neuropsychological assessment can bring clarity to you and the people around you

In my role as a Clinical Neuropsychologist, I often have to help people answer the question, do I have brain damage or brain injury? As I’ll explain, accidents, drugs (including alcohol), and medical conditions can all contribute to brain damage or injury.

In this second part of a three part series explaining what a neuropsychological assessment is, and when you might consider undergoing one, I will address how neuropsychologists approach symptoms of brain injury.

Again, problems or symptoms of problems you might be facing in day-to-day thinking, is a reason we would consider using a neuropsychological assessment because they are very accurate in assessing thinking skills.

As I mentioned last time, thinking skills can be separated into five domains:

• Attention: can you focus on something someone is saying or a picture for a short time and hold the information in a controlled way.
• Memory: can you attend to and focus on something like a proverb or saying and later repeat it back. Or remember a shape you’ve been shown and recognise it from amongst several similar things.
• Planning: Given a simple practical task you’ve never done before can you demonstrate a methodical and organised way to complete it.
• Mental Flexibility: Can you perform two simple tasks simultaneously? For how long can you keep that going?
• Mental Switching: Can you swap between tasks. Can you also tell when you’ve made a mistake, stop yourself and see how to put it right?

When a neuropsychological assessment is better than an educational assessment.

Sadly thinking skills can be affected by life events, especially those giving rise to brain damage or brain injury.

It is very frequent to suffer reduced efficiency and speed in thinking following these types of events:

1. A significant blow to the head, especially if it results in unconsciousness. Even falling backwards onto the back of your head can potentially impact your brain functioning. There has been a lot of coverage in the media of post-concussion syndrome amongst footballers in particular.
2. A period of time with reduced oxygen supply. This is known as a hypoxic event. Some examples can be during medical emergencies such as cardiac arrest or during complicated organ surgery. Despite the best efforts of highly skilled doctors sadly these events can occur.
3. Exposure to toxins. Unfortunately sometimes industrial accidents mean inadvertent exposure to lead, mercury and dangerous solvents.
4. Exposure to recreational drugs. . Why some people are more vulnerable than others is unclear. When taken in large amounts Alcohol can result in a form of dementia and also a condition known as Wernicke Korsakoff’s syndrome.
5. Some chronic medical conditions can result in brain damage. Repeated episodes of very low blood sugar in diabetes can damage thinking skills.

The assessment is an invaluable tool to identify the type of cognitive problems and how severe they are. This can help others understand how a person might be affected but importantly how they may be assisted to overcome or work around the problems.

If you suspect an injury such as one of those described above, it can be very helpful to discuss this with a neuropsychologist.

Through my work as a neuropsychologist, I am familiar with these events and medical illnesses and understand exactly what happens within the brain when these injuries occur.

People often want to know:

1. Are my thinking skills deteriorating? Is there evidence of damage or is it that I am very stressed and emotionally overwhelmed?
2. Could my thinking problems be related to an injury or being exposed to some substance?
3. Are my problems getting worse or better with time?
4. Are my thinking skills so poor that I can no longer safely do the things I used to like study, drive a car or look after my children?

Much more to just an assessment at Attuned Psychology

Importantly there can be some individual differences in you circumstances that can be protective or mean you have a different outcome to someone else with an identical injury.

It is also now clearly understood that following injury the brain starts to recover. The process of recovery can go on for years.

Even if there is evidence of injury, it is really helpful to discuss with a neuropsychologist whether that necessarily means you should stop doing some things. Often there are ways to adapt or even recover your capacities that neuropsychologist are familiar with.

As a neuropsychologist, I will choose the tasks I give you. I will take into account factors including your age, your educational level before your accident and your recovery.

The tasks chosen do vary depending on what the concerns are: Obviously if you’re most worried about your construction skills and your visual processes there might be less focus on language skills and so on.

I have joined Attuned Psychology after working across major childrens and adults hospitals in Adelaide. Éxperience in the acute hospital setting right through to community brain injury rehabilitation enables me to understand how people’s brains change and recover from the earliest time following the trauma right through to years after the initial event.

Importantly, I am trained in both neuropsychology and clinical psychology and so can bring an understanding of how emotional responses to severe injury as well as relationships, personal values and personal experiences interact with the physical side of brain injury.

You will find I will bring a positive approach to any assessment of brain injury because over the years I have been constantly surprised by the many things things that are still possible to do and achieve following brain injury.

If you think a neuropsychological assessment could benefit you, or somebody you know contact us here to discuss making a booking.

Catherine Cheetham,

Clinical Neuropsychologist.