Contribution of the neuropsychological assessment in concussion

IntroductionThe neuropsychological assessment is a cornerstone in the care management of concussion or mild traumatic injury.ObjectiveTo present the different stages of an exhaustive neuropsychological assessment exploring cognitive and behavioral domains.MethodDescription of the value of the main tests available for behavioral and cognitive assessment. The choice of tests is based on the clinical experience and expertise of the authors.ResultsQuestionnaires are mainly used to explore the behavioral sequelae (depression, anxiety or fatigue) and the impact of these potential difficulties in daily life. Four cognitive abilities could be impaired by concussion: attention, memory, visuospatial functions and executive functions. These abilities could be explored with “paper and pencil” tests or with computerized test batteries. While cognitive sequelae in the context of a moderate or a severe traumatic brain injury are consolidated, in the context of concussion, neuropsychological sequelae tend to resolve in a short time. As a consequence, several neuropsychological assessments could be conducting in a short period involving some methodological considerations. Moreover, as concussion could be reported in a Whiplash injury from a car crash with forensic consequences, it is crucial to propose tests to be sure that the weak performance obtained into the neuropsychological assessment is not explained by poor effort and/or malingering.Discussion/conclusionThis article revises these aspects of a neuropsychological assessment in the specific context of concussion.