Screening for Brain Impairment: A Manual for Mental Health Practice

Screening for Brain Impairment: A Manual for Mental Health Practice. 2nd ed

RA Berg, M Franzen and D Wedding

New York: Springer Publishing Co; 1994, 201 pages

Screening for Brain Impairment is an introduction to neuropsychology intended for, in the words of the authors, “general clinicians”. It is a well-written summary of existing material on the subject and is presented in a very accessible way. The authors are experienced neuropsychologists who have published a number of papers and books on this topic.

The first half of the book presents an introduction to neuroanatomy, neuropathology and neurological examinations. This part is apparently intended for a readership with no previous exposure to neurology (i.e., neuroanatomy, neuropathology or clinical examination). It would be appropriate and useful for the social worker who has no experience with brain-impaired patients. However, it is introductory and over-simplistic for other healthcare professionals such as nurses, speech therapists, physicians, occupational- and physiotherapists.

The second half of the book is of much broader interest to the general clinician, and focusses specifically on neuropsychology, its assessment and approaches. These chapters contain a wealth of information related to neuropsychological assessment, its appropriate application and implications. This information is likely to facilitate more effective interaction between the healthcare team and the neuropsychologist. It will also guide the general clinician in conducting a preliminary neuropsychological assessment of the patient.

However, a word of caution is in order. At various points in this book, the authors suggest referring a patient for Anther examination to a neuropsychologist or a neurologist if an undiagnosed neurological disorder is suspected. In my opinion, equating a neuropsychologist with a neurologist is potentially dangerous. Typically, the neuropsychologist has no access to inpatient beds; to neuroimaging diagnostics; to invasive diagnostic procedures (e.g., spinal tap); and to emergency neurosurgical consultation. Valuable time may be lost in a neuropsychological assessment, thereby missing a window of opportunity to diagnose and treat a potentially treatable neurological condition such as subdural hematoma or meningitis.

In summary, this book is a well-written introduction to neuropsychology. Parts of it are oversimplistic for most general clinicians; other parts provide valuable information for people wishing to learn more about assessment devices and concepts of neuropsychology.