Diagnosis of Concussion
A head injury that results in memory loss (post-traumatic amnesia [PTA]), confusion, or a loss of consciousness is diagnosed as a concussion. Although most concussions are mild and do not cause complications, any head injury can be serious and requires medical attention. If you suffer a blow or jolt to the head and may have sustained a concussion, contact a qualified health care provider immediately or call 911.
To diagnose concussion and rule out serious head injury, the physician takes a medical history, obtains information about how the injury occurred, evaluates the symptoms, and performs a physical examination and diagnostic tests (e.g., CT scan).
Questions about the injury may include the following:
- When did the injury occur?
- How did the injury happen?
- If the injury occurred in a motor vehicle accident, was the person properly restrained in a child safety seat or seat belt? How fast was the car moving? Was it a side, rear, or head on collision?
- If the injury was caused by a fall, onto what type of surface did the fall occur? From approximately what height?
- If the injury occurred as the result of another type of impact, such as a collision or blow to the head, with what did the head collide? What area of the head was involved in the impact?
- Was the person wearing protective head gear, a mouth guard, or a helmet?
- Was the injury caused by a jolt to the head?
- Did the person lose consciousness? If so, for how long?
- What symptoms occurred immediately following the injury?
A complete patient history includes information about past and current medical conditions (e.g., chronic illnesses, bleeding disorders), medications, allergies, and prior head injuries.
During a physical exam, the physician evaluates the person's medical condition and assesses neurological function (e.g., mental status, reflexes) to rule out a more serious head injury and look for associated injuries (e.g., neck injury, laceration). The physician examines the ears, nose, and eyes for signs of bruising or bleeding (may indicate skull fracture).
In grade 2 or grade 3 concussions, computed tomography (CT scan) may be performed to rule out more serious head injury, such as bleeding in brain tissue (intracerebral hemorrhage) or beneath the skull (intracranial hemorrhage). CT scan, also called computerized axial tomography (CAT) scan, involves taking a series of x-rays from many different angles to produce cross-sectional images of the brain and skull. The x-rays are processed through a computer to produce three-dimensional (3-D) images called tomograms.
Magnetic resonance imaging (MRI scan) may be performed when complications develop, such as post-concussion syndrome that lasts longer than normal (e.g., months to a year). In MRI scan, electromagnetic radio waves are used to produce detailed images of the brain.