Neuropsychological Evaluation After a Concussion
Understanding Concussion and Its Cognitive Effects
A concussion is a mild traumatic brain injury that causes temporary brain dysfunction without visible lesions on imaging. Although it rarely leaves structural damage, this type of injury frequently triggers cognitive symptoms in the hours and days following the event: difficulties with concentration and attention, memory problems, and slowed information processing. These deficits can significantly disrupt daily life—whether at work, at school, in family life, or during leisure activities—especially if post-concussion syndrome develops. In other words, even a so-called “mild” concussion can have notable consequences on mental functioning and quality of life.
The Role of Neuropsychology in Concussion Assessment
Because the sequelae of concussion are primarily cognitive and functional, the neuropsychologist’s expertise is crucial for assessing their scope. A neuropsychologist is a psychologist specialized in brain functioning, trained in clinical neuroscience, and a member of a recognized professional order. After a concussion, their role is to evaluate the integrity of cognitive functions and clarify the origin of reported symptoms, taking into account the injury history and the individual’s profile.
Unlike medical exams or brain scans, which often appear normal in concussions, neuropsychological testing is far more sensitive in detecting cognitive changes caused by the trauma. A neuropsychological evaluation objectively documents concussion-related cognitive deficits, validates the person’s difficulties, and guides care: academic or workplace accommodations, recommendations for cognitive rest, or referral to other specialists if needed.
The Evaluation Process
A neuropsychological evaluation for concussion unfolds in several structured steps. It begins with a thorough clinical interview to gather information about the injury, symptoms, and relevant history.
The next step is testing. The neuropsychologist administers a battery of standardized tools designed to measure different areas of brain functioning. These in-person tests objectively assess cognitive abilities by comparing results to established norms. The evaluation is often spread across one or two sessions to account for patient fatigue.
Once data collection is complete, the neuropsychologist integrates the results into a detailed analysis and writes a comprehensive report. The findings are then explained to the patient in a feedback session, clarifying conclusions and presenting recommendations.
Cognitive Functions and Areas Assessed
A neuropsychological evaluation after concussion typically explores:
- Attention and concentration
- Short- and long-term memory
- Processing speed
- Executive functions, including planning, organization, and cognitive flexibility
- Emotional and behavioral aspects
Who Should Undergo Such an Evaluation?
Anyone who has sustained a concussion may benefit from a neuropsychological evaluation, especially when:
- Symptoms persist beyond 6 to 8 weeks
- A return to work or sport requires confirmation of no residual deficits
- The person has suffered multiple concussions, increasing the risk of cumulative effects
- A child or adolescent experiences school difficulties after a concussion
- An athlete needs comparison testing with a pre-injury baseline
Neuropsychological Evaluation in Medico-Legal Contexts
Beyond its clinical utility, neuropsychological evaluation also plays an important role in medico-legal contexts. Cognitive sequelae of mild traumatic brain injury are sometimes invisible and may be disputed. An objective report from a neuropsychologist serves as recognized clinical evidence.
In fact, a ruling by the Superior Court of Québec confirmed that only neuropsychologists (and psychiatrists) are authorized to assess the cognitive consequences of a concussion when determining permanent impairment.
This medico-legal dimension is a key asset when an individual’s condition must be officially recognized, whether in the context of litigation, insurance, or claims.
A Tool for Recovery and Recognition
In conclusion, neuropsychological evaluation after a concussion is an essential step in understanding the cognitive impacts of traumatic brain injury, guiding appropriate interventions, and, when necessary, providing objective documentation in legal contexts. With rigor and sensitivity, the neuropsychologist helps each individual better understand their cognitive functioning and protect their brain health.
