Concussion Diagnosis

Concussions can be tricky to diagnose. They are not a structural problem like a visible cut or bruise on your head, they are rather a functional problem, like not being able to concentrate, having a headache, of feeling dizzy. Signs and symptoms may not appear for days or weeks after the injury. Some symptoms may only last seconds, others may linger for much longer.

That is why it is important to evaluate what your symptoms are being caused by, only then can the correct management begin.

Please click here to download a quick evaluation that may help you determine if you or a loved one may be suffering from the signs and symptoms of a concussion.

Assessment

Once a severe injury is ruled out, it is important to assess what type of concussion you have and determine the appropriate treatments.

If you have sustained what you believe Loss of consciousness (LOC) is rare, occurring in less than 10% of concussions, butThe identification of LOC can be very tricky, as the patient may lose consciousness very briefly and this event may not be directly observed by others. By definition, LOC represents a state of brief coma in which the eyes are typically closed and the patient is unresponsive to external stimuli. 

Although helpful in identifying more serious concerns (e.g. skull fracture, hematoma, contusion), traditional neurological and radiologic procedures, such as CT, MRI, and EEG, are not useful in identifying the effects of concussion. Such tests are typically unremarkable or normal, even in athletes sustaining a severe concussion. The reason for this issue is that concussion is a metabolic or functional injury,  rather than a structural injury. Thus, structural neuroimaging techniques are insensitive to the effects of concussion.

Testing

Concussion patients may need testing procedures.  However, it should be noted that the need for advanced imaging in concussion cases is not common.

  • Neurologic examination: This exam allows us to take a detailed look at the various functions of your brain, including reflexes, memory and focus, vision and eye movements, balance and equilibrium, and sensations.  It is the most important part of the concussion assessment.
  • Orthopaedic Examination
  • Soft Tissue Examination
  • Vestibular Examination: This .
  • Vestibulo-Ocular Exam: You may need an x-ray of your neck or head. This is done to check for other injuries, such as a fracture or subluxation..
  • MRI, CT or X-Rays: You may be referred out for advanced imaging to take pictures of your brain, head, blood vessels or skull in more serious injuries.

Diagnosis

Following the above assessments, the diagnosis of concussion or Mild Traumatic Brain Injury (MTBI) will be made providing you with one of the following diagnosis:

Concussion, with no loss of consciousness
Positive injury description with evidence of a direct or indirect forcible blow to the head, plus evidence of active symptoms and/or signs of any type and number related to the trauma; no evidence of LOC, skull fracture, internal bleed (i.e., intracranial injury).

Concussion, with brief loss of consciousness < 1 hour
Positive injury description with evidence of a direct or indirect forcible blow to the head, plus evidence of active symptoms and/or signs of any type and number related to the trauma; positive evidence of LOC; no skull fracture, internal bleed.

Concussion, unspecified
Positive injury description with evidence of a direct or indirect forcible blow to the head, plus evidence of active symptoms and/or signs of any type and number related to the trauma; unclear or unknown injury details and unclear evidence of LOC; no skull fracture, internal bleed.