Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment (AACN Workshop Series) 1st Edition

I'm a military psychiatrist serving with Marines in Afghanistan. Sadly, the last few months' combat operations has resulted in a slew of mTBI cases that have been referred my way. I needed a quick review of the literature on this topic to bring me up to speed, and this book did it. A colleague of mine (also serving out here) highly recommended this text, so I bought it, and was able to quickly get through it. Wonderful chapter on the proposed mechanism of injury, explaining the fascinating neurometabolic cascade the follows a TBI (my previous understanding was limited to "diffuse axonal injury"). Great section on the natural history of TBI that has really helped me frame expectations for my patients. It's rare to find a book that, at once, exhaustively reviews the literature AND is easily-readable and clinically applicable. Bravo Zulu, Dr. McCrea!

Fabulous book! Outcome in mild traumatic brain injury has been the subject of many unfortunate myths that have actually served to harm mild TBI patients. I have seen many mild traumatic brain injury patients who came to believe that they were disabled by their injury, and and as a result were robbed of their quality of life (e.g., left jobs that they were capable of still doing and as a result suffered financial reversals, etc.). This book carefully, thoroughly, and convincingly summarizes the literature showing no longterm cognitive changes in this population. Hopefully, medical professionals will now start acccurately educating their patients as to true outcome in this condition.

Covers all the key issues related to MTBI and does so with the proper balance of research and everyday language. Very reassuring (oddly reassuring?) to me as I try to understand and cope with my MTBI and post-concussion syndrome symptoms. Take your time reading it, though, because it taxes the post-concussion brain! I read multiple chapters in one sitting 3 months post-injury (couldn't put it down) and couldn't function the rest of the day. When I finish the book, I plan to give it to my doctor.

This is an important book for clinicians and neuropsychologists. There has been a great deal of controversy regarding individuals who experience mTBI and then have persistent cognitive symptoms, sometimes for years. Dr. McCrea does an excellent job of reviewing the pertinent literature, with helpful summaries at the end of each chapter. He goes on to lay out a model of PCS as a neuropsychological disorder with multiple sources of causation including pre-existing psychopathology, somatization, lack of social support and contextual issues including litigation. This volume is concise and provides valuable suggestions for the management of PCS.

The first 73 pages of this book are a good review of the fairly recent literature on the subject, though already outdated to some extent. It is a quick read and will bring the reader up to date through the literature published before 2008. After the first third of the book the quality drops precipitously.The remainder of the book presents the theory that residual dysfunction is due to a psychological disorder without an organic basis. The argument masks science, twisting circumstantial findings and opinions as facts, without presenting any real foundation for this position. The argument of whether a post-concussive syndrome is a psychological disorder or represents organic dysfunction is in my opinion outdated and until there is an objective way to measure this question, it is not with debating. For now, we know that a mild brain injury can result in both cognitive and behavioral complaints. These sequalae are not mutually exclusive of one another. Patients suffering from such unfortunate injuries deserve to be treated holistically and with an absence of bias. Ultimately, Dr. MCrea undermines his credibility with his biased perspective.

As an army psychologist working with patients who have moderate to severe as well as mTBI (concussion), I find this book to be the most scientifically sound in terms of understanding brain injury, diagnosing, and making sound assessments. I recommend this book to all neuropsychologists or neurologists; and others who work with patients who suffer from or want to be evaluated for possible brain injuries(s). It is also somewhat of a quick read, which gets to the point; while at the same time citing all appropriate scientific literature.

McCrea is a member of the mTBI deniers association. It's membership is comprised largely of neuropsychologists who have made a cottage industry of doing the forensic dirty work to prevent mTBI pateints from being properly compensated. This book is largely a rudimentary overview of TBI and concussion that then leads the reader into the propaganda of denial. His citation to peer reviewed literature is unbalanced and out of date. The book fails to underscore that the classification of TBI is often misleading as it is dependent upon events and conditions in the immediate post-trauma period rather than recognizing that further deterioration often occurs secondary to changes of brain metabolism and a cascade of neurochemical changes. In addition, McCrea fails to address the significance of advance neuroimaging studies including the use of high field MRI magnets, diffusion tensor imaging and brain volumetric analysis.