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TRAUMATIC BRAIN INJURY.pdf CRC PR ESS Boca Raton London New York Washington, D.C. TRAUMATIC BRAIN INJURY Methods for Clinical and Forensic Neuropsychiatric Assessment ROBERT P. GRANACHER ©2003 CRC Press LLC This book contains information obtained from authentic and highly regarded sources. Reprinted material is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable efforts have been made to publish reliable data and information, but the author and the publisher cannot assume responsibility for the validity of all materials or for the consequences of their use. Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, microfilming, and recording, or by any information storage or retrieval system, without prior permission in writing from the publisher. The consent of CRC Press LLC does not extend to copying for general distribution, for promotion, for creating new works, or for resale. Specific permission must be obtained in writing from CRC Press LLC for such copying. Direct all inquiries to CRC Press LLC, 2000 N.W. Corporate Blvd., Boca Raton, Florida 33431. Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation, without intent to infringe. Visit the CRC Press Web site at www.crcpress.com © 2003 by CRC Press LLC No claim to original U.S. Government works International Standard Book Number 0-8493-1429-1 Library of Congress Card Number 2003046073 Printed in the United States of America 1 2 3 4 5 6 7 8 9 0 Printed on acid-free paper Library of Congress Cataloging-in-Publication Data Granacher, Robert P., 1941- Traumatic brain injury : methods for clinical and forensic neuropsychiatric assessment / Robert P. Granacher, Jr. p. ; cm. Includes bibliographical references and index. ISBN 0-8493-1429-1 (alk. paper) 1. Brain damage—Diagnosis. I. Title. [DNLM: 1. Brain Injuries—complications. 2. Brain Injuries—diagnosis. 3. Expert Testimony. 4. Forensic Psychiatry—methods. 5. Neuropsychological Tests. WL 354 G748t 2003] RC387.5.G73 2003 616.8'0475—dc21 2003046073 Preface Approximately 2 million traumatic head injuries occur in the U.S. yearly. These in turn produce more than 50,000 deaths annually. There is a biphasic distribution of brain injury, with the highest incidence found among young people 15 to 24 years of age and a second group of citizens greater than 75 years of age. Almost 25% of head injuries require hospitalization, and nearly 100,000 persons yearly are left with some level of chronic brain impairment. This text has a specific focus. It provides not only methods for clinical examination but also the forensic evaluation of traumatically brain-injured persons. The reader can be selective in using this book. If he or she is interested only in clinical assessment, treatment planning, and neuropsy- chiatric treatment, the first eight chapters of the book will suffice. On the other hand, for the physician performing a forensic neuropsychiatric examination, the entire book should be useful. If the clinician is already highly skilled in the clinical evaluation of traumatic brain injury but wishes to learn further forensic issues, he or she may focus only on the last four chapters of this text. There is a simple logic to the book. It follows traditional medical evaluation concepts with a neuropsychiatric focus. It demarcates differences in the adult evaluation vs. the child evaluation. Chapter 8 integrates the clinical section of this text, whereas Chapter 11 integrates the forensic section of the text. The seven preceding chapters in the clinical section of the book proceed logically to a culmination of data analysis and case studies in Chapter 8. The same format applies to the forensic section, Chapters 9 to 12. Chapters 9 to 11 provide the forensic analysis database, and Chapter 12 offers the forensic expert guidance for the writing of neuropsychiatric traumatic brain injury reports and the providing of neuropsychiatric testimony. This text is not intended to provide complete information regarding the multiple advances within the entire field of traumatic brain injury. For instance, it provides only a limited focus on management of acute traumatic brain injury. This is better left to neurosurgeons and trauma physicians. Its primary intent is to provide the physician, at some time well after the brain injury, with a clinically tested schema for either evaluating and treating a patient or examining a plaintiff or defendant. The genesis for this text comes from the author’s database of almost 3000 traumatically brain-injured persons, or those alleging a traumatic brain injury, examined by extensive historical, physical, imaging, neuropsychological, and laboratory procedures. It is hoped that the reader will find this to be a practical text providing pragmatic information either for evaluation and treatment of one’s patient or for providing a state-of-the-art forensic examination of an alleged traumatic brain injury. ©2003 CRC Press LLC ...