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Tests and diagnosis
By Mayo Clinic staffIf a blow to your head, neck or upper body has caused symptoms such as a headache, dizziness, nausea or loss of consciousness, you've had a concussion. Signs and symptoms of these injuries may not appear until hours or days after the injury. Brain imaging may be required to determine whether the injury is severe and has caused bleeding or swelling in your skull.
Tests your doctor may perform or recommend include:
Neurological exam
After your doctor asks detailed questions about your injury, he or she may perform a neurological exam. This evaluation includes checking your:
- Memory and concentration
- Vision
- Hearing
- Strength and sensation
- Balance
- Coordination
- Reflexes
Imaging tests
A cranial computerized tomography (CT) scan is the standard test to assess the brain right after injury. A CT scanner takes multiple cross-sectional X-rays and combines all the resulting images to produce detailed, two-dimensional images of your skull and brain. During the procedure, you lie still on a table that slides through a large, doughnut-shaped X-ray machine. The scan is painless and generally takes less than 10 minutes.
Brain imaging isn't always required after a concussive traumatic brain injury. You're more likely to need a scan if you:
- Are an older adult
- Fell from a height of more than 3 feet (1 meter)
- Were hit by a car or ejected from your car seat in a motor vehicle accident
- Are under the influence of alcohol or drugs
- Are unable to recall the accident for at least 30 minutes after it occurred
- Have persistent trouble with short-term memory — that is, retaining new information — after you've completely regained consciousness
- Vomited multiple times
- Had a seizure
- Suffered bruises, scrapes or cuts on your head and neck
- Are confused or have any other neurological symptoms, especially if the symptoms are getting worse
Observation
You may need to be hospitalized overnight for observation after a concussion. If your doctor says it's OK for you to be observed at home, someone should check on you every few hours for at least 24 hours. You may need to be awakened periodically to make sure you can be roused to normal consciousness.
- Head injury. American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Head-Injury.aspx. Accessed Dec. 2, 2010.
- Halstead ME, et al. Clinical report — Sport-related concussion in children and adolescents. Pediatrics. 2010;126:597.
- Heads up: Concussion in youth sports. A fact sheet for parents. Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/pdf/parents_Eng.pdf. Accessed Dec. 2, 2010.
- Traumatic brain injury. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec21/ch310/ch310a.html. Accessed Dec. 2, 2010.
- Evans RW. Concussion and mild traumatic brain injury. http://www.uptodate.com/home/index.html. Accessed Dec. 2, 2010.
- Lovell M. The neurophysiology and assessment of sports-related head injuries. Neurologic Clinics. 2008;26:45.
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- Schutzman S. Minor head trauma in infants and children. http://www.uptodate.com/home/index.html. Accessed Dec. 2, 2010.
- Wetjen NM, et al. Second impact syndrome: Concussion and second injury brain complications. Journal of the American College of Surgeons. 2010;211:553.
- Lovell M. The management of sports-related concussion: Current status and future trends. Clinics in Sports Medicine. 2009;28:95.
- Position statement on sports concussion. American Academy of Neurology. http://www.aan.com/globals/axon/assets/7913.pdf. Accessed Jan. 10, 2010.
- McCrory P, et al. Consensus statement on concussion in sport: 3rd International Conference on Concussion in Sport held in Zurich, November 2008. Clinical Journal of Sport Medicine. 2009;19:185.
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