First off welcome to NeuroTalk. Sounds like there are a couple of dynamics at work here.

Regarding the neuropsychological exam, most of the time these are delivered by a clinical neuropsychologist using some subset of standardized tests for memory as well as other cognative functions. If he scored in the 10th percentile this is compared with baseline scores from people with a similar age, education and so forth. The fact that you didn’t like this psychologist is to a certain extent irrelevant, assuming she or he followed accepted protocol. The neuropsychologist’s role at this point would be to recommend therapy treatments, which would likely include work with a speech and/or occupational therapists; the neuropsychologist isn’t normally the one that does the follow up therapy.

Per your question “is memory loss always from TBI”, there can be other causes of memory deficits, but since you have posted here I will assume your husband has had some form of TBI? TBI can cause memory problems, as I know from personal experience. The fact that he is “confused a lot” is also consistent with TBI patients.

Regarding your “marriage has been difficult” comment, is this related to your husband’s TBI? If so, please consider that many TBI patients make tremendous progress. My wife was my best ally and helped push me to continue my progress. If the difficulties existed before, then only you can answer what your role in his recovery should be.

If you provide more background on when the injury happened, the severity of his TBI, and treatments to date, forum members will be better able to share related experiences and suggestions.

Best to you both.