Discrepancies between standardized measures of cognitive level and Halstead-Reitan impairment indices as inferences of brain damage following head injuries.

Abstract

z scores for measures of intelligence, memory, educational achievement, and neuropsychological impairment were obtained for 193 patients who had sustained impacts of mechanical energy to their skulls. Two sets of normative data, adjusted for age and sex and not adjusted for these variables, were employed to compute indices of neurocognitive proficiency (the inverse of impairment). 80% or 76 of the 96 patients whose Halstead-Reitan Indices were greater than 0.4 displayed scores for neurocognitive proficiency that were two or more standard deviations below the averages of their scores for intelligence, memory, and educational achievement. None of the patents whose Impairment Indices were 0.4 or less displayed this discrepancy. There were no statistically significant differences between these two groups of patients with respect to the presence of unconsciousness following the injury or the duration of posttraumatic memory disruptions. The results indicate that quantitative scores for neuropsychological impairments are still the most accurate criteria to discern brain dysfunction within the mild to moderate range.