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 in children are mild and do not cause complications, any head injury can be serious and requires medical attention. If your child suffers a blow or jolt to the head and may have sustained a concussion, contact his or her pediatrician or another 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 child's 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 child was involved in a motor vehicle accident, was he or she 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 child fall? 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 child collide? What area of the child's head was involved in the impact?
- Was the child wearing protective head gear, a mouth guard, or a helmet?
- Was the injury caused by a jolt to the head?
- Did the child lose consciousness? If so, for how long?
- What symptoms did the child experience 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 child's 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 child's 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 in children who develop complications, 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.
