Neuropsychologic sequelae of non-impact head injury in an older male

A male (WDR) over the age of 50 years was assessed neuropsychologically on three occasions within a five-year period following a motor vehicle accident. He exhibited no physical evidence of a direct blow to the head, behavior following the accident appeared to fulfil the medical criteria for "mild" head injury, physical neurological examinations, and CT and MRI scans yielded negative results, and primary medical diagnoses included compensation neurosis and conversion reaction. Despite these medical findings and conclusions, neuropsychologic data consistently reflected severe brain injury, involving maximally the right cerebral hemisphere. The neuropsychologic results are reviewed and discussed, and rehabilitative efforts are described. Medical diagnostic procedures that are designed to address issues of survival and the preservation of life may not always be suitable to the principal interest of the clinical neuropsychologist, who addresses brain-related adaptability.