Dementia in Head Injury
Exams and Tests for Dementia After a Head Injury continued...
A thorough physical exam will be done to identify neurological and cognitive problems, problems in mental or social function, and unusual appearance, behavior, or mood.
Many health care providers refer head-injured persons for neuropsychological testing. This is the most reliable way to document cognitive impairments following a head injury.
Neuropsychological testing for dementia
Neuropsychological testing is the most sensitive means of identifying dementia in persons with head injury. It is carried out by a specialist trained in this specific area of clinical psychology. The neuropsychologist uses clinical rating scales to identify subtle cognitive problems. This testing also establishes clear baselines for measuring changes over time.
Imaging studies for head injury, dementia
Head injury warrants a brain scan to detect which parts of the brain are injured.
- A CT scan is a type of X-ray that shows details of the brain. It is the standard test in a person who has had a head injury. A scan performed one to three months after injury may detect damage not visible immediately after the injury.
- MRI is more sensitive than CT scan in demonstrating certain types of injury.
- Single-photon emission computed tomography (SPECT) scan is a relatively new imaging method that is still being studied in people with head injuries. It may be better than CT scan or MRI in detecting functional problems in the brain for some types of dementia or other brain disorders. SPECT is available only at some large medical centers.
Other tests for head injury
Electroencephalogram (EEG) measures the electrical activity of the brain. It may be used to diagnose seizures.
Treatment for Dementia in Head Injury
Head injuries often bring an abrupt "coping crisis." The sudden adverse changes that go with a head injury inevitability cause many emotions. Anxiety is a common response, and the person may become demoralized or depressed. Damage to the brain may impair the person’s ability to cope at a time when the need to adapt is greatest. Persons with head injury typically are more distressed and have more difficulty coping with their injury than persons who have other types of injuries.
Usually, a particular family member assumes most of the responsibility for the injured person’s care. Ideally, more than one family member should be closely involved in caregiving. This helps family members share the burdens of providing care and helps the primary caregiver keep from becoming isolated or overwhelmed. Caregivers should be included in all significant interactions with health care professionals.
Caregivers must encourage and expect the injured person to be as independent and productive as possible. At the same time, caregivers need to be patient and tolerant. They should accept that the person may have real limitations and that these will likely worsen if the person is tired, ill, or stressed. Emphasizing what the person can still do, rather than what seems to be lost, is helpful.
With head injuries, the greatest improvement is expected in the first six months, but delayed improvement is possible as long as five years after the injury.