Clinical and Neuropsychological Aspects of Closed Head Injury

Author: John T. Richardson
Published: June 2000
Publisher: Taylor & Francis, Inc.
ISBN: 0863777511
Hardcover Book
Number of Pages: 320

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In all industrialized countries, closed head injuries are responsible for vast numbers of hospital admissions and days of work lost. For instance, about 120,000 patients are admitted to hospital in the United Kingdom each year with a diagnosis that reflects closed head injury. Such injuries are a major cause of deaths following accidents, especially those that involve children and young people, and they are also a major cause of handicap and morbidity among the survivors.
This clinical condition is intrinsically a neurological one, but its proper evaluation demands an understanding of the associated psychology and psychopathology. At the same time, a major neurological condition with such a high level of incidence ought to be extremely informative about the functioning of the human brain and hence provide a major focus for neuropsychological investigation. In this book, the author seeks to integrate these two different perspectives by reviewing the clinical and neuropsychological aspects of closed head injury in a manner that is equally intelligible to researchers interested in the effects of brain damage upon human behavior and to practitioners who are responsible for the assessment, management and rehabilitation of head-injured patients.
This is the second edition of a book which was first published in 1990, and which has been extensively revised in the light of the subsequent research in the field. The book begins by considering the epidemiology, causes and structural neuropathology of closed head injury. It then considers the impact of closed head injury on memory, cognition, language, communication, personality and social behavior. Finally it outlines the outcome, themechanisms of recovery and the prospects for rehabilitation. Departing from the conventional definition of a closed-head injury as one that does not expose the contents of the skull, Richardson (Brunel U.) finds it more useful to characterize it as an injury from a blunt impact rather than a penetration. He discusses such aspects as the mechanisms of structural pathology, retrograde amnesia and post- traumatic amnesia, and memory function. He does not mention a date for the first edition.

Table of Contents
Acknowledgements vii
Series preface ix
Abbreviations x
1. Definitions, epidemiology, and causes 1
Definitions 2
Epidemiology 16
Mortality 26
Causes 30
Overview 36
2. Mechanisms of structural pathology 39
Cerebral contusions 41
Diffuse axonal injury 49
Secondary brain damage 57
Overview 69
3. Retrograde amnesia and post-traumatic amnesia 73
Retrograde amnesia 74
Post-traumatic amnesia 80
Overview 94
4. Memory function 97
Memory function following minor closed head injury 98
Memory function following severe closed head injury 104
Overview 123
5. Cognition and language 125
Cognitive function 125
Verbal and nonverbal intelligence 139
Disorders of language 146
Overview 155
6. Subjective complaints and personality disorders 157
Postconcussional symptoms 157
Personality disorders 176
Family relationships 181
Overview 186
7. Outcome, recovery, and rehabilitation 189
Measures of outcome 189
Recovery of function 204
The process of recovery 216
Rehabilitation 221
Overview 231
References 233
Author index 279
Subject index 288

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