In this video Dr. Nathan Zasler, who is subspecialty certified in brain injury medicine and an internationally known expert in the field of brain injury, reviews current concepts and limitations regarding:
- Concussive brain injury classification
- Treatment and outcomes
He also discusses some of the confounds that lawyers should be aware of in the context of examining cases of claimed concussive brain injury.
Dr. Zasler has also provided several articles that were mentioned during the webinar:
- Validity Assessment in Traumatic Brain Injury Impairment and Disability Evaluations
- Differential diagnosis in cases of claimed post-traumatic brain injury (TBI) impairment requires an understanding of the principles of validity assessment and their application in the context of physical and cognitive-behavioral assessment.
- Clinicians must appreciate the nuances between effort and response bias assessment, and performance and symptom validity testing in the context of assessing anyone with a reported history of TBI, particularly when there are potential secondary gain incentives present that may impact examination validity.
- Practitioners must be aware that there are many reasons for symptom magnification and that the driving factors may not necessarily be consciously mediated or discoverable by the clinician/examiner.
- Validity assessment and the neurological physical examination
The assessment of any patient or examinee with neurological impairment, whether acquired or congenital, provides a key set of data points in the context of developing accurate diagnostic impressions and implementing an appropriate neurorehabilitation program. As part of that assessment, the neurological physical exam is an extremely important component of the overall neurological assessment.
- Post-traumatic Headache – Ch. 25 of APA Publishing Textbook of Traumatic Brain Injury, Third Addition
Although post-traumatic headache (PTHA) has historically been considered as a singular headache disorder following brain/head trauma, a more modern view of this problem suggests that PTHA is not a specific diagnosis but is, instead, a post-traumatic symptom produced by one or more causes that must be identified to treat it effectively.
- Postconcussive Headache –Ch. 6 of Concussion – Assessment, Management and Rehabilitation
Polytrauma, including traumatic brain injury, has been associated with signiﬁcant pain sequelae. Postconcussive headache (PCH) has historically been viewed as a singular headache disorder with some quoting an incidence of headache occurring in nearly 90% of concus-sive brain injuries (CBIs) with a fairly alarming rate of chronicity.
- Medicolegal Issues in Traumatic Brain Injury
- Medicolegal expert testimony in cases involving TBI requires a different skill base than clinical practice.
- Physiatrists involved in medicolegal work involving TBI cases must understand the ethical, legal, and business caveats that come with such undertakings and their disparities from standard clinical practice.
- The standards for assessment and diagnostic formulation in medicolegal work involving persons with TBI must meet current standards. of community practice and opinion and medicolegal testimony (ie, Daubert standards).
- Physiatric examiners must understand and appropriately use medicolegal terminology.
- When providing expert testimony in cases involving TBI, the physiatric examiner must understand how to incorporate preinjury, injury, and post injury information, the latter including but not limited to neurodiagnostics and neuropsychological testing, into their diagnostic formulations and opinions regarding apportionment and causality.
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Dr. Zasler is also happy to answer questions you may have regarding TBI care for your clients.
He can be reached at 888-886-5462, 804-270-5484 or by email.
About Dr. Nathan Zasler:
Board certified specialist in physical medicine and rehabilitation fellowship trained in brain injury and subspecialties certified in brain injury medicine
Has published and written extensively over the last 30+ years on the topic of traumatic brain injury including addressing medical legal issues
Holds numerous editorial roles including as chief editor of the international peer-reviewed journal Brain Injury, as well as chief editor of what is considered to be the core textbook in the field, Brain Injury Medicine: Principles and Practice, now going into its third edition
Founder, CEO, and CMO of the Concussion Care Centre of Virginia, an outpatient interdisciplinary practice in Richmond Virginia providing care to persons with acquired brain injury and post-trauma pain
Founder, CEO, and CMO of Tree of Life Services which is a transitional and long-term care assisted living program in Richmond Virginia which has been providing care to persons with acquired brain injuries since 1998