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Tests and diagnosis
By Mayo Clinic staffBecause traumatic brain injuries are usually emergencies and because consequences can worsen swiftly without treatment, doctors usually need to assess the situation rapidly.
Glasgow Coma Scale
This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person's ability to follow directions and move their eyes and limbs. The coherence of speech also provides important clues. Abilities are scored numerically. Higher scores mean milder injuries.
Information about the injury and symptoms
If you observed someone being injured or arrived immediately after an injury, you may be able to provide medical personnel with information that's useful in assessing the injured person's condition. Answers to the following questions may be beneficial in judging the severity of injury:
- How did the injury occur?
- Did the person lose consciousness?
- How long was the person unconscious?
- Did you observe any other changes in alertness, speaking, coordination or other signs of injury?
- Where was the head or other parts of the body struck?
- Can you provide any information about the force of the injury? For example, what hit the person's head, how far did he or she fall, or was the person thrown from a vehicle?
- Was the person's body whipped around or severely jarred?
Imaging tests
- CT scans. Computerized tomography (CT) is a specialized X-ray technology that can produce thin cross-sectional images of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions) and brain tissue swelling.
- MRIs. Magnetic resonance imaging (MRI) uses a magnetic field and radio waves to produce cross-sectional or 3-D images of soft tissues. Doctors rarely use MRIs during emergency assessments of traumatic brain injuries because the procedure takes too long to complete. The device may be used after a person's condition has been stabilized.
Intracranial pressure monitor
Tissue swelling from a traumatic brain injury can increase pressure inside the skull and cause additional damage to the brain. Doctors may insert a probe through the skull to monitor this pressure.
- Living with brain injury: Education. Brain Injury Association of America. http://www.biausa.org/education.htm. Accessed July 8, 2010.
- Heads up: Facts for physicians about mild traumatic brain injury. Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/headsup/physicians_tool_kit.html. Accessed July 7, 2010.
- Traumatic brain injury: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/tbi/detail_tbi.htm. Accessed July 8, 2010.
- Ling GS, et al. Management of traumatic brain injury in the intensive care unit. Neurologic Clinics. 2008;26:409.
- Nolan S. Traumatic brain injury: A review. Critical Care Nursing Quarterly. 2005;28:188.
- Living with brain injury: Treatment and rehabilitation. Brain Injury Association of America. http://www.biausa.org/treatmentandrehab.htm. Accessed July 8, 2010.
- Traumatic brain injury. Family Caregiver Alliance. http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=579. Accessed July 21, 2010.
- Coping with behavior problems after head injury. Family Caregiver Alliance. http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=396. Accessed July 21, 2010.
- Brown AW (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 11, 2010.
- Traumatic brain injury in the United States: Emergency department visits, hospitalizations and deaths, 2002-2006. Centers for Disease Control and Prevention. http://www.cdc.gov/TraumaticBrainInjury. Accessed Aug. 16, 2010.
- Military & veterans. BrainLine.org. http://www.brainline.org/landing_pages/categories/military.html. Accessed Aug. 23, 2010.
- Thinking/cognitive symptoms. BrainLine.org. http://www.brainline.org/landing_pages/categories/cognitivesymptoms.html. Accessed Aug. 23, 2010.
- Barbara Woodward Lips Patient Education Center. Understanding brain injury: A guide for the family. Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2008. http://mayoresearch.mayo.edu/mayo/research/tbims/upload/ubi_families.pdf. Accessed Aug. 23, 2010.
- Moessner AM (expert opinion). Mayo Clinic, Rochester, Minn. August 16, 2010.
- Behavioral and emotional symptoms. BrainLine.org. http://www.brainline.org/landing_pages/categories/behavioralsymptoms.html. Accessed Aug. 23, 2010.
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