Principles and Practice
Brain Injury
Medicine
EDITED BY
N
ATHAND. Z
ASLER, MD D
OUGLASI. K
ATZ, MD R
OSSD. Z
AFONTE, DO
Principles and Practice
Brain Injury Medicine
New York
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© 2007 by Demos Medical Publishing, LLC. All rights reserved. This book is protected by copyright.
No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.
Chapter 21, “The Older Adult” by Jeffrey Englander, David X. Cifu, and Trinh Tran, is an updated version of the chapter that originally appeared in the book, Rehabilitation of the Adult and Child with Traumatic Brain Injury, Third Edition, edited by M. Rosenthal, E.R. Griffith, J.S. Kreutzer, and B. Pentland, published by F.A. Davis in 1999.
Medicine is an ever-changing science undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. The authors, editors, and publisher have made every effort to ensure that all information in this book is in accordance with the state of knowledge at the time of production of the book.
Nevertheless, this does not imply or express any guarantee or responsibility on the part of the authors, editors, or publisher with respect to any dosage instructions and forms of application stated in the book. Every reader should examine carefully the package inserts accompanying each drug and check—if necessary, in consultation with a physician or specialist—whether the dosage schedules mentioned therein or the contraindications stated by the manufacturer differ from the statements made in this book. Such examination is particularly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the reader’s own risk and responsibility. The editors and publisher welcome any reader to report to the publisher any discrepancies or inaccuracies noticed.
About the Cover: In vivo, noninvasive, three-dimensional reconstruction of the motor tract pathways using white matter tractography and diffusion tensor imaging techniques. Image courtesy of Dr. Mariana Lazar.
Cover design by Steven Pisano.
Library of Congress Cataloging-in-Publication Data
Brain injury medicine : principles and practice / edited by Nathan D. Zasler, Douglas I. Katz, Ross D. Zafonte.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-1-888799-93-4 (alk. paper) ISBN-10: 1-888799-93-5 (alk. paper)
1. Brain—Wounds and injuries—Patients—Rehabilitation. 2. Brain—Wounds and injuries—Patients—Care. 3. Continuum of care.
[DNLM: 1. Brain Injuries. 2. Continuity of Patient Care. WL 354 B81386 2006]
I. Zasler, Nathan D., 1958– II. Katz, Douglas. III. Zafonte, Ross D.
RD594.B727 2006 617.4'810443—dc22
2006006039
06 07 08 09 10 5 4 3 2 1
Manufactured in the United States of America
T
he three of us wish to thank all the contributors who agreed to take time to author chapters and share their expertise with the readers of this textbook. We hope that readers will be pleased with the quality and diversity of the various medical, rehabilitative, and other specialists who enabled this book to come to fruition. We believe the scope and multidisciplinary nature of this textbook add important dimensions to its overall value as a primary resource to you, the practitioner.We would also like to thank the individuals at Demos Medical Publishing for their patience with this project. A special thanks to Dr. Diana Schneider for her leadership as well as her willingness to compromise.
Additionally, we thank Craig Percy and Edith Barry who were essential along with other Demos staff in seeing this text come to completion.
Lastly, we would like to dedicate this book to all indi- viduals with brain injuries, their families, and the profes- sionals who are committed to serve and assist them in such a way as to optimize their potential to work, play, and love once again.
NZ, DK, RZ As chief editor of this textbook, I would like to thank my co-editors, Dr. Douglas Katz of HealthSouth Brain- tree Rehabilitation Hospital and Boston University, Department of Neurology, and Dr. Ross Zafonte of University of Pittsburgh, Department of Physical Medi- cine and Rehabilitation, for their knowledge, patience, and expertise in assisting with the editing (and writing)
of this rather enormous undertaking. I know that each gentleman entered into the project never anticipating the tremendous amount of work and time that would ulti- mately be required. That said, I would like to thank each of you for your commitment to the project and your willingness to see it through.
I would like to personally thank a number of individuals who have served as professional role models in my career. One such individual is Dr. Henry H.
Stonnington under whom I initially trained. He needs to be mentioned as a major guiding force for my decision to enter into the field of brain injury medicine and reha- bilitation. I am deeply grateful to Dr. Stonnington for sharing his vision regarding brain injury care. I am also grateful for Dr. Stonnington’s major contributions to the field, including founding the International Association for the Study of Traumatic Brain Injury which eventu- ally merged with the International Brain Injury Associa- tion of which I currently serve as Chairperson. He was also the founder of the first major journal in the field of brain injury rehabilitation, Brain Injury (Taylor &
Francis, London). I would also be remiss to not include Dr. Sheldon Berrol and Dr. Catherine Bontke, both now deceased, and Dr. Lawrence Horn as significant profes- sional role models in molding my career goals and practice philosophy.
On a more personal note I would like to thank my beautiful and understanding wife, Lisa Nava Marcelle Zasler, for her love, vitality, and family values, and in particular her patience with regard to my level of pro- fessional commitment to my work. Without her as a
A cknowledgments
v
stabilizing and energizing force in my life, I would cer- tainly not have the ability to sustain such a level of pro- fessional motivation. I must also recognize my three beautiful children— Maia, Anya, and Aaron, who light up every single day of my life and make the world a much brighter place to live in. It is with great hope that by the time these children are adults, we will be much further along in assuring that individuals with brain injury and their families do not incur the type of sorrow, grief, lack of knowledge and/or resources, as well as long-term adverse consequences that so many of our patients today must often and unfortunately experience. I also hope that my brother Jonathan would be proud of my accom- plishments, both personally and professionally. Most importantly, I want to thank my parents, Moshe and Joyce Zasler, who have always encouraged me to pursue my dreams and stood by me through “thick and thin.”
Thanks for being the best.
NZ I also thank my co-editors, especially Dr. Nathan Zasler for setting high standards and keeping us moving forward and on target during this ambitious project. I would also like to acknowledge all those who have taught, influenced, supported, inspired, and collaborated with me through- out my career, especially my teachers, neurorehabilitation fellows, colleagues and fellow staff at Braintree Rehabil- itation Hospital and Boston University. In particular, I would like to mention: Michael P. Alexander, MD, my
mentor and colleague, who continues to serve as a teacher and role model for me; Virginia Mills, MS, PT, who, as a colleague, friend, and leader, has inspired me and taught me much about brain injury rehabilitation and how to do it right; T. Joy DePiero, MD, my neurorehabilitation partner at Braintree Rehabilitation Hospital, who has been an exceptional colleague, source of knowledge, and support over the last 20 years; my patients and their fam- ilies who have taught me and inspired me so much over the years; and most importantly, my wonderful family: my wife Kim, my children Rachel and Daniel, and my parents Carol (1924–2004) and Warner, who have been a never- ending source of love and support during my time- consuming professional career.
DK I would like to express my gratitude to my late parents, Albert and Grace. They instilled in me a desire to con- tinually improve and to always maintain a sense of curiosity. My sincere appreciation goes toward my men- tors, too numerous to mention, because they have helped shape my views and focus my enthusiasm throughout the years. To my wife, Cheryl, and son, Alexander, who have given their time to this and many other projects. I am struck by their patience and caring. Most of all, for this project I would like to acknowledge the people with brain injury whom I have had the opportunity to serve. We have grown and learned together, and we will continue to do so.
RDZ
Preface xiii
Foreword by Henry H. Stonnington xv
Contributors xvii
I PERSPECTIVES ON REHABILITATIVE CARE AND RESEARCH 1. Clinical Continuum of Care and Natural History
Douglas I. Katz, Nathan D. Zasler, and Ross D. Zafonte 3
2. Brain Injury Rehabilitation: Past, Present, and Future?
George A. Zitnay 15
3. International Perspectives on TBI Rehabilitation
Zeev Groswasser and Ofer Keren 21
4. Training and Certification of Care Providers for Persons Sustaining TBI
Margaret A. Turk and Joanne Scandale 27
5. Conducting Research in TBI: Current Concepts and Issues
Amy K. Wagner 33
II EPIDEMIOLOGY, PREVENTION, NEUROPATHOLOGY, AND NEURAL RECOVERY
6. The Epidemiology of TBI: Implications for Public Health
David J. Thurman, Victor Coronado, and Anbesaw Selassie 45
7. Primary Prevention
Elena Napolitano, Jeffrey Radecki, and Elie P. Elovic 57
vii
C ontents
8. TBI: Pathobiology
Patrick M. Kochanek, Robert S.B. Clark, and Larry W. Jenkins 81
9. Concepts of CNS Plasticity and Their Implications for Understanding Recovery After Brain Damage
Donald G. Stein 97
10. Advances in Innovative Therapies to Enhance Neural Recovery
C. Edward Dixon and Anthony E. Kline 109
III NEUROIMAGING AND NEURODIAGNOSTIC TESTING 11. Static Neuroimaging in the Evaluation of TBI
John M. Barkley, Denise Morales, L. Anne Hayman, and Pedro J. Diaz-Marchan 129
12. Functional Neuroimaging of TBI
Joseph H. Ricker and Patricia M. Arenth 149
13. Electrophysiologic Assessment Techniques:
Evoked Potentials and Electroencephalography
Henry L. Lew, Eun Ha Lee, Steven S.L. Pan, and Jerry Y.P. Chiang 157
IV PROGNOSIS AND OUTCOME
14. Prognosis After Severe TBI: A Practical, Evidence-Based Approach
Sunil Kothari 169
15. Neuroimaging Correlates of Functional Outcome
Erin D. Bigler 201
16. Functional Assessment in TBI Rehabilitation
Marcel Dijkers and Brian Greenwald 225
17. Life Expectancy
Robert M. Shavelle, David J. Strauss, Steven M. Day, and Kelly A. Ojdana 247
V ACUTE CARE
18. TBI: Pathology, Pathophysiology, Acute Care and
Surgical Management, Critical Care Principles, and Outcomes
Eli M. Baron and Jack I. Jallo 265
19. Assessment, Early Rehabilitation Intervention, and Tertiary Prevention
W. Jerry Mysiw, Lisa P. Fugate, and Daniel M. Clinchot 283
VI REHABILITATIVE CARE AND TREATMENT OF SPECIFIC POPULATIONS 20. TBI: A Pediatric Perspective
Andrew I. Sumich, Maureen R. Nelson, and James T. McDeavitt 305
21. The Older Adult
Jeffrey Englander, David X. Cifu, and Trinh Tran 315
22. Mild TBI
Grant L. Iverson, Rael T. Lange, Michael Gaetz, and Nathan D. Zasler 333
23 Post-Concussive Disorder
Grant L. Iverson, Nathan D. Zasler, and Rael T. Lange 373
24. Sport-Related Concussion
Michael W. Collins, Grant L. Iverson, Michael Gaetz, and Mark R. Lovell 407
25. Assessment and Rehabilitative Management of Individuals with Disorders of Consciousness
Joseph T. Giacino, Douglas I. Katz, and Nicholas Schiff 423
VII NEUROLOGIC PROBLEMS
26. Post-Traumatic Seizures and Epilepsy
Stuart A. Yablon and Victor G. Dostrow 443
27. Movement Disorders After TBI
Joachim K. Krauss and Joseph Jankovic 469
28. Balance and Dizziness
Neil T. Shepard, Richard A. Clendaniel, and Michael Ruckenstein 491
29. Evaluating and Treating Visual Dysfunction
William V. Padula, Lezheng Wu, Vincent Vicci, John Thomas,
Christine Nelson, Daniel Gottleib, Penelope Suter, Thomas Politzer, and Raquel Benabib 511
30. Cranial Nerve Disorders
Flora M. Hammond and Brent E. Masel 529
31. Fatigue: Assessment and Treatment
Jonathan L. Fellus and Elie P. Elovic 545
32. Sleep Disturbances: Epidemiology, Assessment, and Treatment
Lora L. Thaxton and Amish R. Patel 557
33. Diagnosis and Management of Late Intracranial Complications of TBI
David F. Long 577
CONTENTS ix
VIII NEUROMUSCULOSKELETAL PROBLEMS
34. Complications Associated with Immobility After TBI
Kathleen R. Bell 605
35. Assessing and Treating Muscle Overactivity in the Upper Motoneuron Syndrome
Nathaniel H. Mayer, Alberto Esquenazi, and Mary Ann E. Keenan 615
IX MEDICAL MANAGEMENT ISSUES 36. Gastrointestinal and Nutritional Issues
Donald F. Kirby, Linda Creasey, and Souheil G. Abou-Assi 657
37. Sexuality, Reproduction, and Neuroendocrine Disorders Following TBI
M. Elizabeth Sandel, Richard Delmonico, and Mary Jean Kotch 673
38. Post-Traumatic Pain Disorders: Medical Assessment and Management
Nathan D. Zasler, Lawrence J. Horn, Michael F. Martelli, and Keith Nicholson 697
39. Psychological Approaches to Comprehensive Pain Assessment and Management Following TBI
Michael F. Martelli, Keith Nicholson, and Nathan D. Zasler 723
40. Neurorehabilitation Nursing of Persons with TBI:
From Injury to Recovery
Terri Antoinette 743
X COGNITIVE AND BEHAVIORAL PROBLEMS 41. Cognitive Rehabilitation
Keith D. Cicerone 765
42. Cognitive Impairments After TBI
Paul J. Eslinger, Giuseppe Zappalà, Freeman Chakara, and Anna M. Barrett 779
43. Neuropsychological Assessment and Treatment of TBI
Laura A. Taylor, Lee A. Livingston, and Jeffrey S. Kreutzer 791
44. Principles of Behavioral Analysis and Modification
Robert L. Karol 815
45. Neuropsychiatric Aspects of TBI
Thomas W. McAllister 835
XI SPEECH, LANGUAGE, AND SWALLOWING PROBLEMS 46. Assessment and Treatment of Speech and Language
Disorders in TBI
Bruce E. Murdoch and Brooke-Mai Whelan 865
47. Evaluation and Treatment of Swallowing Problems After TBI
Jeri A. Logemann 887
48. Cognitive-Communication Deficits Following TBI
Carl A. Coelho 895
XII MOTOR RECOVERY, FUNCTIONAL MOBILITY, AND ACTIVITIES OF DAILY LIVING
49. Neuroscientific Basis for Occupational and Physical Therapy Interventions
Randolph J. Nudo and Numa Dancause 913
50. Therapy Interventions for Mobility Impairments and Motor Skill Acquisition After TBI
Katherine J. Sullivan 929
51. Therapy for Activities of Daily Living: Theoretical and Practical Perspectives
Robin McNeny 947
XIII NEUROPSYCHOPHARMACOLOGY AND ALTERNATIVE TREATMENTS
52. Pharmacotherapy of Neuropsychiatric Disturbances
Jonathan M. Silver and David B. Arciniegas 963
53. Pharmacotherapy of Cognitive Impairment
David B. Arciniegas and Jonathan M. Silver 995
54. Neuropharmacology: A Rehabilitation Perspective
Jay M. Meythaler, Ross D. Zafonte, Lisa Lombard, and Cara Camiolo Reddy 1023
55. Nutraceuticals
Jeffrey S. Hecht 1037
56. Traditional Chinese Medicine Theory in the Mechanism and Treatment of TBI
Gary G. Wang 1051
57. Complementary and Alternative Medicine
Jacinta McElligott, Alan M. Davis, Jeffrey S. Hecht, Sunil Kothari, John A. Muenz, Jr.,
and Gary G. Wang 1061
CONTENTS xi
XIV PSYCHOSOCIAL AND VOCATIONAL ISSUES 58. Community Reentry Issues and Long-Term Care
Sally Kneipp and Allen Rubin 1085
59. The Treatment of Substance Abuse in Persons with TBI
John D. Corrigan 1105
60. A Cognitive-Behavioral Intervention for Family Members of Persons with TBI
Angelle M. Sander 1117
61. Return to Work Following TBI
Michael West, Pam Targett, Satoko Yasuda, and Paul Wehman 1131
XV MEDICOLEGAL AND ETHICAL ISSUES 62. Medicolegal Aspects of TBI
Irvin V. Cantor 1151
63. Ethical Issues in Clinicolegal Practice
Arthur Ameis, Nathan D. Zasler, Michael F. Martelli, and Shane S. Bush 1163
64. Assessment of Response Bias in Clinical and Forensic Evaluations of Impairment Following TBI
Michael F. Martelli, Keith Nicholson, Nathan D. Zasler, and Mark C. Bender 1183
65. Decision-Making Capacity After TBI: Clinical Assessment and Ethical Implications
Sunil Kothari and Kristi Kirschner 1205
66. Life Care Planning After TBI: Clinical and Forensic Issues
Roger O. Weed and Debra E. Berens 1223
Index
1241B
rain Injury Medicine: Principles and Practice is designed as a comprehensive text for all clinicians deal- ing with the assessment, management, and rehabilitation of patients with traumatic brain injury (TBI) from “coma to community.” This book examines numerous aspects of brain injury with perspectives from an internationally respected group of authors, who include both “in the trenches” practitioners as well as researchers. We hope that this text will serve as a “go-to reference” for clini- cal practitioners to use in day-to-day practice, students and trainees learning about TBI, and other professionals who need to learn more about TBI and its management.The text opens with a description of the clinical continuum of care and the natural history of TBI, fol- lowed by perspectives on rehabilitative care in the United States and other countries, with discussions on training and research. Public health issues are discussed with chapters on epidemiology and prevention. The effects of trauma and recovery on the brain are described in chapters on pathophysiology, brain plasticity, and treat- ments that may influence neural recovery. Readers will learn up-to-date information on technologies to assess TBI, including structural and functional neuroimaging
xiii
P reface
and electrophysiologic techniques. A series of chapters covers prognosis and outcome, including life-expectancy.
The bulk of the text deals with clinical care of patients with TBI—across the continuum of care, at different levels of severity, and among different age groups. There are dis- cussions of the full gamut of medical assessment and man- agement of neurologic, medical, physical, cognitive, and behavioral problems resulting from TBI. Given the biopsy- chosocial nature of TBI and its consequences, there are also chapters on the psychological, neuropsychological, psy- chosocial, ethical, and medicolegal aspects of this condition.
Ultimately, the 66 chapters in this comprehensive text will provide readers with a full complement of med- ical and interdisciplinary rehabilitation perspectives on the assessment and management of persons with mild to severe TBI. It is hoped that this text brings together knowledge, experience, and evidence-based medicine in a manner that will promote further cross-disciplinary practice and research in the field of TBI. Most of all, we hope that this book will result in individuals with TBI receiving timely and accurate assessments and appropri- ate management to optimize their outcomes as well as the quality of their lives and those who care for them.
Nathan D. Zasler, MD Douglas I. Katz, MD Ross D. Zafonte, DO
W
e are what our brains allow us to be. A traumatic brain injury (TBI) changes a person as an individual and has an impact on the ability to interact with his or her environment. The neurorehabilitation of persons who have had a traumatic brain injury requires an extraordi- narily diverse knowledge base and expertise in order to optimize both neurological and functional outcome and minimize medical, as well as psychosocial, morbidity. In an ideal scenario, the neurorehabilitationist facilitates maximal community independence, patient self-reliance, and community re-integration relative to work, leisure, and social interactions while maintaining psychoemo- tional health.TBI may cause changes that affect cognition, behav- ior, language, somatic function, and neuromedical status.
Such an injury can have a negative impact on the complex biopsychosocial relationships that we all have in our environment. Brain injury, in and of itself, can create addi- tional and unexpected problems depending upon the age of the individual at the time of injury. Sometimes, these problems may not be readily apparent early after an injury, but may instead develop later, as the child “grows into” brain injury problems. The neurorehabilitation process should ideally start in the intensive care unit and continue through optimal community reintegration and medical stablization. For some patients, this stage never comes, and chronic care is therefore necessary.
The neuromedical and rehabilitative management of TBI demands a vast knowledge of a multiplicity of fields including neurophysiology, neuroanatomy, neuropathol- ogy, neurology, neuropharmacology, neuropsychiatry,
physiatry, psychology, neuropsychology, orthopedics, nursing, therapy specialties including occupational ther- apy, physical therapy, speech language pathology, and therapeutic recreation, among others. Based on exten- sive experience over the years, an interdisciplinary team approach clearly facilitates optimal neurorehabilitation.
In order to optimize this process, all clinicians on the team must have a good understanding of how to optimize the efficacy of this treatment model and coordinate care in a manner that is most cost-efficient relative to achieving optimal functional outcomes.
Persons with TBI need to have a continuum of pro- grams available in order to facilitate continuity of care and optimize their outcomes. The specific approaches may differ across the continuum of care, as might the medically indicated clinicians. Each of these stages poten- tially requires a different and evolving knowledge. Ade- quate appreciation of clinical nuances is paramount in being able to judge, document, and predict recovery and future neurorehabilitative needs. Functional gains can continue for years, even well after neurologic plateaus are reached. Even in scenarios where one finds that patients have functionally plateaued, there may still be opportu- nities to manipulate the environment and/or provide new treatment methodologies to further optimize quality-of- life and functional status.
Given the complexities in the medical management of this patient population and the need for a functional, holistic approach that utilizes a biopsychosocial model of care, clinicians need a source of information that brings together the myriad medical and allied health specialties
F oreword
xv
involved in understanding TBI care and rehabilitation.
This is the importance of Brain Injury Medicine: Princi- ples and Practice. This book will provide readers with the most recent information and methodologies to facilitate clinical practice and optimize patient functional outcomes.
The text provides the knowledge necessary to understand what is happening at various stages of recovery follow- ing TBI and, more importantly, what needs to be done during each stage. It is an excellent resource for both clinicians and non-clinicians alike. Medical physicians involved in neurorehabilitation, such as physiatrists or neurologists, as well as other rehabilitation team mem- bers, will find this book an invaluable resource. Physicians who deal with TBI in a non-neurorehabilitation context
will certainly benefit from understanding brain injury from the perspective provided by this text, which will further facilitate use of rehabilitation resources in their own community. It is an outstanding and comprehensive book that can serve as the “bible” for each member of a team working with a TBI patient, allowing each of them to understand the reasons behind the decisions of their fellow team members.
We are what our brains allow us to be. The neu- rorehabilitation professional needs to have a standard by which to understand and advise patients, family mem- bers, fellow professionals, and payors regarding TBI- related issues. This book will significantly enable each professional to have access to this vast fund of knowledge.
Henry H. Stonnington, MBBS, MSc, FRCPE, FAFRM (RACP), FAAPM&R Medical Director, Rehabilitation Services, Memorial Hospital
Clinical Professor, Section of PM&R, Department of Internal Medicine
Louisiana State University Medical School
Souheil G. Abou-Assi, MD Gastrointestinal Specialists, Inc.
Richmond, Virginia
Chapter 36: Gastrointestinal and Nutritional Issues Arthur Ameis, MD, FRCPC
Medical Director
Multi-Disciplinary Assessment Centre Toronto, Ontario
Canada
Chapter 63: Ethical Issues in Clinicolegal Practice Terri Antoinette, MHSA, CRRN
Chief Executive Officer
Legal Nurse and Clinical Services Consultants Canonsburg, Pennsylvania
Chapter 40: Neurorehabilitation Nursing of Persons with TBI: From Injury to Recovery
David B. Arciniegas, MD Director
Neurobehavioral Disorders Program
Associate Professor of Psychiatry and Neurology University of Colorado School of Medicine Medical Director
Brain Injury Rehabilitation Unit
HealthONE Spalding Rehabilitation Hospital Aurora, Colorado
Chapter 52: Pharmacotherapy of Neuropsychiatric Disturbances
Chapter 53: Pharmacotherapy of Cognitive Impairment
Patricia M. Arenth, PhD Assistant Professor
Department of Physical Medicine and Rehabilitation University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Chapter 12: Functional Neuroimaging of TBI John M. Barkley, MD
Staff Radiologist
Diagnostic and Interventional Radiology The Methodist Hospital
Houston, Texas
Chapter 11: Static Neuroimaging in the Evaluation of Traumatic Brain Injury
Eli M. Baron, MD Fellow
Cedars–Sinai Institute for Spinal Disorders Los Angeles, California
Chapter 18: TBI: Pathology, Pathophysiology, Acute Care and Surgical Management, Critical Care Principles and Outcomes
C ontributors
xvii
Anna M. Barrett, MD Associate Professor
Departments of Physical Medicine and Rehabilitation, Neurology, and Neurosciences
University of Medicine and Dentistry of New Jersey New Jersey Medical School
Newark, New Jersey
Director of Stroke Rehabilitation
Kessler Medical Rehabilitation Research and Education Corporation
West Orange, New Jersey
Chapter 42: Cognitive Impairments After TBI Kathleen R. Bell, MD
Professor
Department of Rehabilitation Medicine University of Washington
Seattle, Washington
Chapter 34: Complications Associated with Immobility After TBI
Raquel Munitz Benabib, MS COVT Psychologist, Vision Therapist
Centro de Aprendizaje de Cuernavaca Cuernavaca Morelos, Mexico
Chapter 29: Evaluating and Treating Visual Dysfunction Mark C. Bender, PhD
Rehabilitation Neuropsychologist Medical Psychology Department Sheltering Arms Rehabilitation Richmond, Virginia
Chapter 64: Assessment of Response Bias in Clinical and Forensic Evaluations of Impairment
Following TBI
Debra E. Berens, MS, CLCP Private Practice
Rehabilitation Consultant/Life Care Planner Atlanta, Georgia
Chapter 66: Life Care Planning After TBI: Clinical and Forensic Issues
Erin D. Bigler, PhD Professor
Departments of Psychology and Neuroscience Brigham Young University
Provo, Utah
Adjunct Professor of Psychiatry University of Utah School of Medicine Salt Lake City, Utah
Chapter 15: Neuroimaging Correlates of Functional Outcome
Shane S. Bush, PhD Independent Practice Smithtown, New York
Chapter 63: Ethical Issues in Clinicolegal Practice
Irvin V. Cantor, JD Managing Director Complex Litigation Group Cantor Arkema, PC Attorneys At Law Richmond, Virginia
Chapter 62: Medicolegal Aspects of TBI Freeman M. Chakara, PsyD
Clinical Neuropsychologist Providence Behavioral Health Leola, Pennsylvania
and
Lancaster Regional Medical Center Lancaster, Pennsylvania
Chapter 42: Cognitive Impairments After TBI Jerry Y.P. Chiang, MD
Research Fellow
Stanford University School of Medicine Physical Medicine and Rehabilitation Service VA Palo Alto Health Care System
Palo Alto, California
Chapter 13: Electrophysiologic Assessment Techniques:
Evoked Potentials and Electroencephalography Keith D. Cicerone, PhD
Director of Neuropsychology and Rehabilitation Psychology
Department of Physical Medicine and Rehabilitation JFK Johnson Rehabilitation Institute
Edison, New Jersey
Chapter 41: Cognitive Rehabilitation David X. Cifu, MD
The Herman J. Flax, MD Professor and Chairman Department of Physical Medicine and Rehabilitation Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 21: The Older Adult Robert S.B. Clark, MD Associate Professor
Departments of Critical Care Medicine and Pediatrics University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania Chapter 8: TBI: Pathobiology Richard A. Clendaniel, PT, PhD Assistant Professor
Doctor of Physical Therapy Division
Department of Community and Family Medicine Duke University Medical Center
Durham, North Carolina
Chapter 28: Balance and Dizziness
Daniel M. Clinchot, MD
Associate Dean for Medical Education and Outreach Medical Director of the Clinical Skills Education and
Assessment Center
Associate Professor and Program Director
Department of Physical Medicine and Rehabilitation The Ohio State University College of Medicine Columbus, Ohio
Chapter 19: Assessment, Early Rehabilitation Intervention, and Tertiary Prevention Carl A. Coelho, PhD
Professor and Chair
Communication Sciences Department University of Connecticut
Storrs, Connecticut
Chapter 48 : Cognitive-Communication Deficits Following TBI
Michael W. Collins, PhD Assistant Director
UPMC Sports Concussion Program Assistant Professor
Department of Orthopedics Division of Sports Medicine
University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 24 : Sport-Related Concussion Victor G. Coronado, MD, MPH Medical Officer
National Center for Injury Prevention and Control Division of Injury Response
Centers for Disease Control and Prevention Atlanta, Georgia
Chapter 6: The Epidemiology of TBI: Implications for Public Health
John D. Corrigan, PhD Professor
Department of Physical Medicine and Rehabilitation The Ohio State University College of Medicine Columbus, Ohio
Chapter 59: The Treatment of Substance Abuse in Persons with TBI
Linda Creasey, RD, CNSD Clinical Nutrition Supervisor Food and Nutrition Services Medical College of Virginia
Virginia Commonwealth University Richmond, Virginia
Chapter 36: Gastrointestinal and Nutritional Issues
Numa Dancause, PT, PhD Post-Doctorate Fellow Department of Neurology University of Rochester Rochester, New York
Chapter 49: Neuroscientific Basis for Occupational and Physical Therapy Interventions
Alan M. Davis, MD, PhD Assistant Professor
Department of Physical Medicine and Rehabilitation University of Utah School of Medicine
Salt Lake City, Utah
Chapter 57: Complementary and Alternative Medicine Steven M. Day, PhD
Senior Researcher Life Expectancy Project San Francisco, California Chapter 17: Life Expectancy Richard L. Delmonico, PhD Chief, Neuropsychology
Kaiser Foundation Rehabilitation Center Vallejo, California
Associate Clinical Professor University of California, Davis School of Medicine
Davis, California
Chapter 37: Sexuality, Reproduction, and Neuroendocrine Disorders Following TBI Pedro Diaz-Marchan, MD
Associate Professor of Radiology Associate Chair for Education
Program Director, Diagnostic Radiology Residency Program Director, Neuroradiology Fellowship Baylor College of Medicine
Chief of Neuroradiology Ben Taub General Hospital Houston, Texas
Chapter 11: Static Neuroimaging in the Evaluation of TBI
Marcel P.J.M. Dijkers, PhD Associate Professor
Department of Rehabilitation Medicine Mount Sinai School of Medicine New York, New York
Chapter 16: Functional Assessment in TBI Rehabilitation
CONTRIBUTORS xix
C. Edward Dixon, PhD
Director, Brain Trauma Research Center
Professor, Departments of Neurological Surgery, Critical Care Medicine, Neurobiology,
and Physical Medicine and Rehabilitation University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 10: Advances in Innovative Therapies to Enhance Neural Recovery
Victor G. Dostrow, MD Service Chief
Department of Neurology Mississippi State Hospital Whitfield, Mississippi Clinical Associate Professor Department of Neurology
University of Mississippi Medical Center Clinical Assistant Professor
Department of Psychiatry
University of Mississippi Medical Center Adjunct Associate Professor
Department of Pharmacy Practice
University of Mississippi School of Pharmacy Jackson, Mississippi
Chapter 26: Post-Traumatic Seizures and Epilepsy Elie P. Elovic, MD
Director, Traumatic Brain Injury Lab
Kessler Medical Rehabilitation Research and Education Corporation
Associate Professor
Department of Physical Medicine and Rehabilitation University of Medicine and Dentistry of New Jersey New Jersey Medical School
West Orange, New Jersey Chapter 7: Primary Prevention
Chapter 31: Fatigue: Assessment and Treatment Jeffrey Englander, MD
Vice Chair and Director of Brain Injury Rehabilitation Co-Director, NIDRR TBI Model System of Care,
Northern California
Santa Clara Valley Medical Center San Jose, California
Chapter 21: The Older Adult Paul J. Eslinger, PhD
Professor
Departments of Neurology, Neural and Behavioral Sciences,
Pediatrics and Radiology
Pennsylvania State University, College of Medicine and Milton S. Hershey Medical Center
University Hospital Rehabilitation Center Hershey, Pennsylvania
Chapter 42: Cognitive Impairments After TBI
Alberto Esquenazi, MD
Director, Gait and Motion Analysis Laboratory Co-Director, Neuroorthopedic Program MossRehab Elkins Park, Pennsylvania
Chapter 35: Assessing and Treating Muscle Overactivity in the Upper Motoneuron Syndrome
Jonathan L. Fellus, MD Assistant Clinical Professor Department of Neurosciences
University of Medicine and Dentistry of New Jersey New Jersey Medical School
Newark, New Jersey
Director of Brain Injury Services Kessler Institute for Rehabilitation West Orange, New Jersey
Chapter 31: Fatigue: Assessment and Treatment Lisa P. Fugate, MD, MSPH
Assistant Professor
Department of Physical Medicine and Rehabilitation The Ohio State University College of Medicine Columbus, Ohio
Chapter 19: Assessment, Early Rehabilitation Intervention, and Tertiary Prevention Michael Gaetz, PhD
Professor
UCFV Concussion Management Program Kinesiology and Physical Education University College of the Fraser Valley Abbotsford, British Columbia
Canada
Chapter 22: Mild TBI
Chapter 24: Sport-Related Concussion Joseph T. Giacino, PhD
Associate Director of Neuropsychology JFK Johnson Rehabilitation Institute New Jersey Neuroscience Institute Edison, New Jersey
Chapter 25: Assessment and Rehabilitative Management of Individuals with Disorders of Consciousness
Daniel D. Gottlieb, OD Director
Gottlieb Vision Group Stone Mountain, Georgia
Chapter 29: Evaluating and Treating Visual Dysfunction Brian Greenwald, MD
Assistant Professor
Department of Rehabilitation Medicine Mount Sinai School of Medicine New York, New York
Chapter 16: Functional Assessment in TBI Rehabilitation
Zeev Groswasser, MD, MPH Head
Department of Brain Injury Rehabilitation Loewenstein Rehabilitation Hospital Ra’anana, Israel
Professor
Sackler Faculty of Medicine Tel Aviv University
Tel Aviv, Israel
Chapter 3: International Perspectives on TBI Rehabilitation
Flora M. Hammond, MD Brain Injury Program Director Research Director
Department of Physical Medicine and Rehabilitation Carolinas Rehabilitation
Charlotte, North Carolina
Chapter 30: Cranial Nerve Disorders L. Anne Hayman, MD
Private Practice
Department of Radiology Medical Clinic of Houston LLP Houston, Texas
Chapter 11: Static Neuroimaging in the Evaluation of Traumatic Brain Injury
Jeffrey S. Hecht, MD
Associate Professor and Chief Division of Surgical Rehabilitation Department of Surgery
University of Tennessee Graduate School of Medicine Medical Director
The Rehabilitation Center at Baptist Hospital Medical Director
St. Mary’s RehabCare Center Knoxville, Tennessee
Chapter 55: Nutraceuticals
Chapter 57: Complementary and Alternative Medicine Lawrence J. Horn, MD
Professor
Department of Physical Medicine and Rehabilitation Wayne State University School of Medicine
Medical Director
Traumatic Brain Injury Program Rehabilitation Institute of Michigan Detroit, Michigan
Chapter 38: Post-Traumatic Pain Disorders: Medical Assessment and Management
Grant L. Iverson, PhD, RPsych Professor
Department of Psychiatry University of British Columbia
Coordinator of Psychology and Neuropsychology Services
Neuropsychiatry Program Riverview Hospital
Vancouver, British Columbia Canada
Chapter 22: Mild TBI
Chapter 23: Post-Concussive Disorder Chapter 24: Sport-Related Concussion Jack I. Jallo, MD, PhD
Associate Professor
Department of Neurosurgery
Temple University School of Medicine Philadelphia, Pennsylvania
Chapter 18: TBI: Pathology, Pathophysiology, Acute Care and Surgical Management, Critical Care Principles and Outcomes
Joseph Jankovic, MD Professor of Neurology
Director, Parkinson’s Disease Center and Movement Disorders Clinic
Department of Neurology Baylor College of Medicine Houston, Texas
Chapter 27: Movement Disorders After TBI Larry W. Jenkins, PhD
Associate Professor
Department of Neurosurgery
University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 8: Traumatic Brain Injury: Pathobiology Robert L. Karol, PhD
Director
Department of Psychology and Neuropsychology Program Director
Brain Injury Services Bethesda Hospital St. Paul, Minnesota
Chapter 44: Principles of Behavioral Analysis and Modification
CONTRIBUTORS xxi
Douglas I. Katz, MD Associate Professor Department of Neurology
Boston University School of Medicine Boston, Massachusetts
Medical Director Brain Injury Programs
Healthsouth Braintree Rehabilitation Hospital Braintree, Massachusetts
Chapter 1: Clinical Continuum of Care and Natural History
Chapter 25: Assessment and Rehabilitative Management of Individuals with Disorders of Consciousness
Mary Ann E. Keenan, MD
Professor and Vice Chair of Graduate Medical Education
Chief, Neuro-Orthopedics Program University of Pennsylvania Health System Department of Orthopedic Surgery Philadelphia, Pennsylvania
Chapter 35: Assessing and Treating Muscle Overactivity in the Upper Motoneuron Syndrome
Ofer Keren, MD
Director of Rehabilitation Department Alyn Hospital
Pediatric and Adolescent Rehabilitation Center Jerusalem, Israel
Professor
Sackler Faculty of Medicine Tel Aviv University
Tel Aviv, Israel
Chapter 3: International Perspectives on TBI Rehabilitation
Donald F. Kirby, MD
Professor of Medicine, Psychiatry, Biochemistry and Molecular Physics
Chief, Section of Nutrition Medical College of Virginia
Virginia Commonwealth University Richmond, Virginia
Chapter 36: Gastrointestinal and Nutritional Issues Kristi L. Kirschner, MD
Coleman Foundation Chair in Rehabilitation Medicine Director, Donnelley Family Disability Ethics Program Rehabilitation Institute of Chicago
Associate Professor
Departments of Physical Medicine and Rehabilitation and Medical Humanities and Bioethics
Northwestern University Feinberg School of Medicine Chicago, Illinois
Chapter 65: Decision-Making Capacity After TBI:
Clinical Assessment and Ethical Implications
Anthony E. Kline, PhD Assistant Professor
Departments of Physical Medicine and Rehabilitation and Psychology
Associate Director of Rehabilitation Research Safar Center for Resuscitation Research University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 10: Advances in Innovative Therapies to Enhance Neural Recovery
Sally Kneipp, PhD
Director, Community Skills Program Counseling and Rehabilitation, Inc.
Wyomissing, Pennsylvania
Counseling and Rehabilitation of New Jersey, Inc.
Marlton, New Jersey
Chapter 58: Community Re-entry Issues and Long-Term Care
Patrick M. Kochanek, MD Professor and Vice Chairman
Department of Critical Care Medicine
Director, Safar Center for Resuscitation Research University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 8: TBI: Pathobiology Mary Jean Kotch MSN, CRRN-A Clinical Nurse Specialist
Kaiser Foundation Rehabilitation Center and Hospital Vallejo, California
Chapter 37: Sexuality, Reproduction, and Neuroendocrine Disorders Following TBI Sunil Kothari, MD
Associate Director
Brain Injury and Stroke Program
The Institute for Rehabilitation and Research Assistant Professor
Department of Rehabilitation Medicine Baylor College of Medicine
Houston, Texas
Chapter 14: Prognosis After Severe Traumatic Brain Injury: A Practical, Evidence-Based Approach Chapter 57: Complementary and Alternative Medicine Chapter 65: Decision-Making Capacity After TBI:
Clinical Assessment and Ethical Implications Joachim K. Krauss, MD
Professor of Neurosurgery Director and Chairman Department of Neurosurgery Medical University, MHH Hannover, Germany
Chapter 27: Movement Disorders After TBI
Jeffrey S. Kreutzer, PhD, ABPP Professor
Departments of Physical Medicine and Rehabilitation, Neurosurgery, and Psychiatry
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 43: Neuropsychological Assessment and Treatment of TBI
Rael T. Lange, PhD
Research Scientist (Neuropsychology) Department of Research
Riverview Hospital
Coquitlam, British Columbia Canada
Chapter 22: Mild TBI
Chapter 23: Post-Concussive Disorder Eun Ha Lee, MD, PhD
Research Fellow and Clinical Coordinator Stanford University School of Medicine Physical Medicine and Rehabilitation Service VA Palo Alto Health Care System
Palo Alto, California
Chapter 13: Electrophysiologic Assessment Techniques:
Evoked Potentials and Electroencephalography Henry L. Lew, MD, PhD
Clinical Associate Professor
Stanford University School of Medicine Physical Medicine and Rehabilitation Service VA Palo Alto Health Care System
Palo Alto, California
Chapter 13: Electrophysiologic Assessment Techniques:
Evoked Potentials and Electroencephalography Lee A. Livingston, PsyD
Clinical Psychologist and Instructor
Department of Physical Medicine and Rehabilitation Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 43: Neuropsychological Assessment and Treatment of TBI
Lisa A. Lombard, MD Assistant Professor
Medical Director, Traumatic Brain Injury Rehabilitation Department of Physical Medicine and Rehabilitation University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Chapter 54: Neuropharmacology: A Rehabilitation Perspective
Jerilyn A. Logemann, PhD Ralph and Jean Sundin Professor Communication Sciences and Disorders Northwestern University
Evanston, Illinois
Chapter 47: Evaluation and Treatment of Swallowing Problems After TBI
David F. Long, MD
Brain Injury Program Director Bryn Mawr Rehabilitation Hospital Malvern, Pennsylvania
Chapter 33: Diagnosis and Management of Late Intracranial Complications of TBI
Mark R. Lovell, PhD Director
UPMC Sports Medicine Concussion Program Associate Professor of Orthopedics
Division of Sports Medicine
University of Pittsburgh Medical Center Pittsburgh, Pennsylvania
Chapter 24: Sport-Related Concussion Michael F. Martelli, PhD
Director, Rehabilitation Neuropsychology Concussion Care Centre of Virginia, Ltd.
and Tree of Life Services, Inc.
Glen Allen, Virginia Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 38: Post-Traumatic Pain Disorders: Medical Assessment and Management
Chapter 39: Psychological Approaches to
Comprehensive Pain Assessment and Management Following TBI
Chapter 63: Ethical Issues in Clinicolegal Practice Chapter 64: Assessment of Response Bias in Clinical
and Forensic Evaluations of Impairment Following TBI
Brent E. Masel, MD
President and Medical Director
Transitional Learning Center at Galveston Galveston, Texas
Chaper 30: Cranial Nerve Disorders Nathaniel H. Mayer, MD
Emeritus Professor of Physical Medicine and Rehabilitation
Temple University School of Medicine Philadelphia, Pennsylvania
Director, Drucker Brain Injury Center and Motor Control Analysis Laboratory
MossRehab Einstein at Elkins Park Elkins Park, Pennsylvania
Chapter 35: Assessing and Treating Muscle Overactivity in the Upper Motoneuron Syndrome
CONTRIBUTORS xxiii
Thomas W. McAllister, MD Professor of Psychiatry Director of Neuropsychiatry Department of Psychiatry Dartmouth Medical School Lebanon, New Hampshire
Chapter 45: Neuropsychiatric Aspects of TBI James T. McDeavitt, MD
Senior Vice President
Division of Education and Research Carolinas HealthCare System Charlotte, North Carolina
Chapter 20: TBI: A Pediatric Perspective Jacinta M. McElligott, MD
Director of Rehabilitation National Rehabilitation Hospital Dun Laoghaire
Co. Dublin, Ireland
Chapter 57: Complementary and Alternative Medicine Robin McNeny, BS, OTR/L
Manager
Inpatient Occupational Therapy and Therapeutic Recreation
Occupational and Physical Therapy Department Virginia Commonwealth University
Medical College of Virginia Hospitals Medical Center Richmond, Virginia
Chapter 51: Therapy for Activities of Daily Living:
Theoretical and Practical Perspectives Jay M. Meythaler, MD, JD
Chairman and Professor
Department of Physical Medicine and Rehabilitation Wayne State University
Specialist and Chief
Department of Physical Medicine and Rehabilitation Detroit Medical Center
Detroit, Michigan
Chapter 54: Neuropharmacology: A Rehabilitation Perspective
Denise Morales, MD Attending Physician
Department of Physical Medicine and Rehabilitation Kaiser Foundation Rehabilitation Center
Vallejo, California
Chapter 11: Static Neuroimaging in the Evaluation of TBI
John A. Muenz, Jr., MD Private Practice
Physical Medicine and Rehabilitation, Family Medicine Associate Professor
Departments of Family Medicine, Orthopaedics, and Neurology
University of Florida—Jacksonville Jacksonville, Florida
Chapter 57: Complementary and Alternative Medicine
Bruce E. Murdoch, PhD, DSc Professor
Head School of Health and Rehabilitation Sciences The University of Queensland
St. Lucia, Brisbane Australia
Chapter 46: Assessment and Treatment of Speech and Language Disorders in TBI
W. Jerry Mysiw, MD Associate Professor
Bert C. Wiley Chair and Vice Chair
Department of Physical Medicine and Rehabilitation The Ohio State University College of Medicine Columbus, Ohio
Chapter 19: Assessment, Early Rehabilitation Intervention, and Tertiary Prevention Elena Napolitano, MD
Attending Physiatrist
Department of Physical Medicine and Rehabilitation Shore Rehabilitation Institute
Brick, New Jersey
Chapter 7: Primary Prevention Christine A. Nelson, PhD, OTR Clinical Coordinator
Centro de Desarrollo Cuernavaca, Mexico
Chapter 29: Evaluating and Treating Visual Dysfunction
Maureen R. Nelson, MD
Director, Pediatric Rehabilitation Services Carolinas Rehabilitation
Physical Medicine and Rehabilitation Charlotte, North Carolina
Clinical Associate Professor
Department of Physical Medicine and Rehabilitation University of North Carolina
Chapel Hill, North Carolina
Chapter 20: TBI: A Pediatric Perspective
Keith Nicholson, PhD Psychologist
Comprehensive Pain Program The Toronto Western Hospital University of Toronto
Toronto, Ontario Canada
Chapter 38: Post-Traumatic Pain Disorders: Medical Assessment and Management
Chapter 39: Psychological Approaches to
Comprehensive Pain Assessment and Management following TBI
Chapter 64: Assessment of Response Bias in Clinical and Forensic Evaluations of Impairment
Following TBI Randolph J. Nudo, PhD Professor
Department of Molecular and Integrative Physiology Director, Landon Center on Aging
The University of Kansas Medical Center Kansas City, Kansas
Chapter 49: Neuroscientific Basis for Occupational and Physical Therapy Interventions
Kelly A. Ojdana, MS Researcher
Life Expectancy Project San Francisco, California Chapter 17: Life Expectancy William V. Padula, OD Director
Padula Institute of Vision Rehabilitation Guilford, Connecticut
Adjunct Faculty
Pennsylvania College of Optometry Elkins Park, Pennsylvania
Chairperson, National Academy of Practice in Optometry (NAPO)
Founding President (Emeritus), Neuro-Optometric Rehabilitation Association (NORA)
Chapter 29: Evaluating and Treating Visual Dysfunction Steven S. L. Pan, MD
Research Fellow
Stanford University School of Medicine Physical Medicine and Rehabilitation Service VA Palo Alto Health Care System
Palo Alto, California
Chapter 13: Electrophysiologic Assessment Techniques:
Evoked Potentials and Electroencephalography Amish R. Patel, DO
Resident
Department of Physical Medicine and Rehabilitation Medical College of Ohio
Toledo, Ohio
Chapter 32: Sleep Disturbances: Epidemiology, Assessment, and Treatment
Thomas Politzer, OD Private Practice Golden, Colorado
Chapter 29: Evaluating and Treating Visual Dysfunction Jeffrey Radecki, MD
Department of Physical Medicine and Rehabilitation New York-Presbyterian
The University Hospital of Columbia and Cornell New York, New York
Chapter 7: Primary Prevention Cara Camiolo Reddy, MD
Traumatic Brain Injury Fellow and Clinical Instructor Department of Physical Medicine and Rehabilitation University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Chapter 54: Neuropharmacology: A Rehabilitation Perspective
Joseph H. Ricker, PhD Associate Professor
Department of Physical Medicine and Rehabilitation University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania
Chapter 12: Functional Neuroimaging of TBI Allen J. Rubin, MD
The Center for Neuropsychiatry, LLC Marlton, New Jersey
Adjunct Associate Professor of Clinical Psychiatry Drexel University School of Medicine
Philadelphia, Pennsylvania
Chapter 58: Community Re-entry Issues and Long-Term Care
Michael Ruckenstein, MD Associate Professor
Residency Program Director
Department of Otorhinolaryngology, Head and Neck Surgery
Hospital of the University of Pennsylvania Philadelphia, Pennsylvania
Chapter 28: Balance and Dizziness M. Elizabeth Sandel, MD
Chief, Physical Medicine and Rehabilitation Napa Solano Service Area
Director, Research and Training
Kaiser Foundation Rehabilitation Center Vallejo, California
Clinical Professor
Department of Physical Medicine and Rehabilitation University of California, Davis, School of Medicine Davis, California
Chapter 37: Sexuality, Reproduction, and Neuroendocrine Disorders Following TBI
CONTRIBUTORS xxv
Angelle M. Sander, PhD
Assistant Professor and Neuropsychologist
Department of Physical Medicine and Rehabilitation Baylor College of Medicine/Harris County Hospital
District
Associate Director
Brain Injury Research Center at The Institute for Rehabilitation and Research
Houston, Texas
Chapter 60: A Cognitive-Behavioral Intervention for Family Members of Persons with TBI
Joanne Scandale, PhD, CRC, CCM, LMHC Program Director of Vocational Services Department of Rehabilitation
Hutchings Psychiatric Center Syracuse, New York
Chapter 4: Training and Certification of Care Providers for Persons Sustaining TBI Nicholas D. Schiff, MD
Associate Professor
Department of Neurology and Neuroscience Weill Medical College of Cornell University New York, New York
Chapter 25: Assessment and Rehabilitative Management of Individuals with Disorders of Consciousness Anbesaw Selassie, DrPH
Associate Professor of Epidemiology
Department of Biostatistics, Bioinformatics, and Epidemiology
Medical University of South Carolina Charleston, Carolina
Chapter 6: The Epidemiology of TBI: Implications for Public Health
Robert M. Shavelle, PhD, MBA Technical Director
Life Expectancy Project San Francisco, California Chapter 17: Life Expectancy Neil T. Shepard, PhD Professor
Department of Special Education and Communication Disorders
University of Nebraska, Lincoln Lincoln, Nebraska
Chapter 28: Balance and Dizziness Jonathan M. Silver, MD
Clinical Professor of Psychiatry
New York University School of Medicine New York, New York
Chapter 52: Pharmacotherapy of Neuropsychiatric Disturbances
Chapter 53: Pharmacotherapy of Cognitive Impairment
Donald G. Stein, PhD Asa G. Candler Professor
Department of Emergency Medicine Emory University School of Medicine Atlanta, Georgia
Chapter 9: Concepts of CNS Plasticity and Their Implications for Understanding Recovery After Brain Damage
David J. Strauss, PhD Director
Life Expectancy Project Emeritus Professor University of California San Francisco, California Chaper 17: Life Expectancy Katherine J. Sullivan, PhD, PT
Assistant Professor of Clinical Physical Therapy Director, Entry-level Doctor of Physical Therapy Department of Biokinesiology and Physical Therapy University of Southern California
Los Angeles, California
Chapter 50: Therapy Interventions for Mobility Impairments and Motor Skill Acquisition After TBI Andrew Sumich, MD
Private Practice
Physical Medicine and Rehabilitation Carolina Neurosurgery and Spine Associates Charlotte, North Carolina
Chapter 20: TBI: A Pediatric Perspective Penelope S. Suter, OD
Optometrist in Private Practice Research Associate
California State University Bakersfield, California
Chapter 29: Evaluating and Treating Visual Dysfunction
Pam Targett, MEd
Rehabilitation Research and Training Center Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 61: Returning to Work Following TBI Laura A. Taylor, PhD
Licensed Clinical Psychologist Village Family Psychiatry Richmond, Virginia
Chapter 43: Neuropsychological Assessment and Treatment of TBI
Lora L. Thaxton, MD
Optimal Life Integrative Medicine Pain Center Toledo, Ohio
Chapter 32: Sleep Disturbances: Epidemiology, Assessment, and Treatment
John A. Thomas, OD Adjunct Professor
Pacific University College of Optometry Director
Head Trauma, Vision, Cognitive and Learning Disabilities Center
Denver, Colorado
Chapter 29: Evaluating and Treating Visual Dysfunction David J. Thurman, MD, MPH
Neuroepidemiologist
National Center for Chronic Disease Prevention and Health Promotion
Centers for Disease Control and Prevention Atlanta, Georgia
Chapter 6: The Epidemiology of TBI: Implications for Public Health
Trinh Tran, MD Clinical Instructor
University of California San Francisco School of Medicine
Laguna Hospital and Rehabilitation Center San Francisco, California
Chapter 21: The Older Adult Margaret A. Turk, MD Professor
Department of Physical Medicine and Rehabilitation Department of Pediatrics
SUNY Upstate Medical Center Syracuse, New York
Chapter 4: Training and Certification of Care Providers for Persons Sustaining TBI Vincent Richard Vicci, Jr., OD
Staff Vision Care Consultant Kessler Institute for Rehabilitation West Orange, New Jersey
Staff Vision Care Consultant Extended Recovery Unit
Robert Wood Johnson Rehabilitation Unit JFK Memorial Hospital
Edison, New Jersey
Chapter 29: Evaluating and Treating Visual Dysfunction
Amy K. Wagner, MD Assistant Professor
Department of Physical Medicine and Rehabilitation Associate Director Rehabilitation Research
Safar Center for Resuscitation Research University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania
Chapter 5: Conducting Research in TBI: Current Concepts and Issues
Gary G. Wang, MD Director
Traumatic Brain Injury Program Erie County Medical Center Buffalo, New York
Chapter 56: Traditional Chinese Medicine Theory in the Mechanism and Treatment of TBI
Chapter 57: Complementary and Alternative Medicine Roger O. Weed, PhD, CLCP
Professor and Coordinator
Graduate Rehabilitation Counseling Program
Department of Counseling and Psychological Services Georgia State University
Atlanta, Georgia
Chapter 66: Life Care Planning After TBI: Clinical and Forensic Issues
Michael West, PhD
Rehabilitation Research and Training Center Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 61: Returning to Work Following TBI Paul Wehman, PhD
Rehabilitation Research and Training Center Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 61: Returning to Work Following TBI Brooke-Mai Whelan, PhD
Research Fellow
Division of Speech Pathology
School of Health and Rehabilitation Sciences The University of Queensland
St. Lucia, Brisbane Australia
Chapter 46: Assessment and Treatment of Speech and Language Disorders in TBI
CONTRIBUTORS xxvii
Lezheng Wu, MD
Professor of Ophthalmology Zhangshan Ophthalmic Center Sun Yat-Sen University
Guangzhou, Canton China
Chapter 29: Evaluating and Treating Visual Dysfunction
Stuart A. Yablon, MD
Director, The Brain Injury Program Methodist Rehabilitation Center Jackson, Mississippi
Chapter 26: Post-Traumatic Seizures and Epilepsy Satoko Yasuda, PhD
Rehabilitation Research and Training Center Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Chapter 61: Returning to Work Following TBI Ross D. Zafonte, DO
Professor and Chair
Department of Physical Medicine and Rehabilitation University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania
Chapter 1: Clinical Continuum of Care and Natural History
Chapter 54: Neuropharmacology: A Rehabilitation Perspective
Giuseppe Zappalà, MD
Behavioral Neurology and Cognitive Rehabilitation Division of Neurology
Garibaldi Hospital Catania, Italy
Chapter 42: Cognitive Impairments After TBI
Nathan D. Zasler, MD CEO and Medical Director
Concussion Care Centre of Virginia, Ltd.
and Tree of Life Services, Inc.
Glen Allen, Virginia Clinical Professor
Department of Physical Medicine and Rehabilitation Medical College of Virginia
Virginia Commonwealth University School of Medicine Richmond, Virginia
Clinical Associate Professor
Department of Physical Medicine and Rehabilitation University of Virginia
Charlottesville, Virginia
Chairperson, International Brain Injury Association Chapter 1: Clinical Continuum of Care and Natural
History
Chapter 22: Mild TBI
Chapter 23: Post-Concussive Disorder
Chapter 38: Post-Traumatic Pain Disorders: Medical Assessment and Management
Chapter 39: Psychological Approaches to
Comprehensive Pain Assessment and Management Following TBI
Chapter 63: Ethical Issues in Clinicolegal Practice Chapter 64: Assessment of Response Bias in Clinical
and Forensic Evaluations of Impairment Following TBI
George A. Zitnay, PhD, ABDA CBIS-CE Director
National Brain Injury Research Treatment and Training Foundation
Laurel Highlands Neurorehabilitation Center Johnstown, Pennsylvania
Chapter 2: Brain Injury Rehabilitation: Past, Present, and Future?
PERSPECTIVES ON
REHABILITATIVE CARE AND RESEARCH
I
SCOPE OF THE PROBLEM AND THE CHARACTERISTICS OF TRAUMATIC
BRAIN INJURY
Systems of care for patients with traumatic brain injury (TBI) must account for the particular characteristics of this disorder. First, TBI is among the most common of serious, disabling neurological disorders. It is a significant problem in all societies. In the United States at least 1.4 million TBIs occur every year, and there are 5.3 million people living with disability from TBI (1–3). (See Thur- man et al., Chapter 6, for a full discussion of the epi- demiology of TBI). Systems of care must allocate resources for the large number of people who are affected by the disorder.
Second, TBI is largely a younger and older person’s disorder (2). Individuals younger than 30, mostly males, make up the largest proportion of those affected. TBI usu- ally impacts people who are in the later stages of adoles- cent development or in early adulthood. Therefore, TBI typically disrupts important periods of life involving edu- cational and social development, emerging vocational productivity and adult independence, and beginning spousal relationships and family development. Older per- sons present particular problems related to aging includ- ing co-morbidities, slower and less complete recovery, and vulnerability to complications of injury and treatment (4) (see Englander et al., Chapter 21 on “The Older Adult”).
Systems of care must address needs that include special educational requirements, independent living, vocational training and supports, and supports for family members.
Third, TBI commonly affects people with preexist- ing problems such as substance abuse, learning disabili- ties, behavioral disorders, psychiatric disorders and other risk factors that may make people more prone to injuries.
In addition, persons with brain injury are more prone to psychiatric co-morbidities and psychosocial difficulties following injury. Systems of care must consider these pre- injury and post-injury issues with respect to injury pre- vention, their interactions with the clinical effects of injury and potential detrimental influence on recovery from TBI.
Fourth, the most important and consistent effects of TBI involve cognitive, emotional, and behavioral func- tioning. Motor and sensory perceptual problems also occur in varying amounts, more likely in those with more severe injuries. Cognitive and behavioral problems pre- sent more challenges to the health care system because they are often more difficult to recognize, characterize, and treat than traditional medical and physical problems.
Persons with TBI, particularly less severe injuries, may not have any obvious physical markers of the injury, though there may be profound effects on the individual’s ability to function, largely resulting from cognitive or behavioral dysfunction. Criteria for medical rehabilitation reimbursement, length of stay, and utilization decisions are
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