Imaging studies are not the only objective findings in medicine. Neurological science has developed based upon the premise that a "footprint of pathology" is objective evidence of injury. When a person cannot see, even if we cannot pinpoint the cause of the blindness, this "footprint of pathology" tells us that there is damage. When a person cannot hear, likewise this "footprint of pathology" tells us that there is injury.
When a neurological exam shows focal neurological deficits, this is a "footprint of pathology". All of these are "objective evidence of injury".
Neuropsychological testing is essentially a "footprint of pathology" and as such is objective evidence of injury. Neuropsychological testing is based upon the theory that by measuring and assessing how the brain is functioning, we can determine if there is a pathology.
Neuropsychological testing can objectively determine the brain's current capacities. Then, by comparing the pattern of these results, with the patients pre-morbid capabilities, and correlating these results with the nature of the trauma suffered by the patient, neuropsychologists can establish and confirm a diagnosis of brain injury.
Source: Definition of Mild Traumatic Brain Injury Developed by the Mild Traumatic Brain Injury Committee of the Head Injury Interdisciplinary Special Interest Group of the American Congress of Rehabilitation Medicine. J Head Trauma Rehabil 1993:8(3):86-87
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