Diagnosis

Your doctor will evaluate your signs and symptoms, review your medical history, and conduct a neurological examination. Signs and symptoms of a concussion may not appear until hours or days after the injury.

Tests your doctor may perform or recommend include:

Neurological examination

After your doctor asks detailed questions about your injury, he or she may perform a neurological examination. This evaluation includes checking your:

  • Vision
  • Hearing
  • Strength and sensation
  • Balance
  • Coordination
  • Reflexes

Cognitive testing

Your doctor may conduct several tests to evaluate your thinking (cognitive) skills during a neurological examination. Testing may evaluate several factors, including your:

  • Memory
  • Concentration
  • Ability to recall information

Imaging tests

Brain imaging may be recommended for some people with symptoms such as severe headaches, seizures, repeated vomiting or symptoms that are becoming worse. Brain imaging may determine whether the injury is severe and has caused bleeding or swelling in your skull.

A cranial computerized tomography (CT) scan is the standard test to assess the brain right after injury. A CT scan uses a series of X-rays to obtain cross-sectional images of your skull and brain.

Magnetic resonance imaging (MRI) may be used to identify changes in your brain or to diagnose complications that may occur after a concussion. An MRI uses powerful magnets and radio waves to produce detailed images of your brain.

Observation

You may need to be hospitalized overnight for observation after a concussion.

If your doctor agrees that you may be observed at home, someone should stay with you and check on you for at least 24 hours to ensure your symptoms aren't worsening.

Your caregiver may need to awaken you regularly to make sure you can awaken normally.

Feb. 10, 2017
References
  1. Evans RW. Concussion and mild traumatic brain injury. http://www.uptodate.com/home. Accessed Oct. 2, 2016.
  2. Sprouse RA, et al. Sport-related concussion: How best to help young athletes. The Journal of Family Practice. 2016;65:538.
  3. Concussion: What can I do to feel better after a concussion? Centers for Disease Control and Prevention. http://www.cdc.gov/traumaticbraininjury/recovery.html. Accessed Oct. 2, 2016.
  4. Signs and symptoms. Centers for Disease Control and Prevention. http://www.cdc.gov/traumaticbraininjury/symptoms.html. Accessed Oct. 2, 2016.
  5. What is a concussion? Centers for Disease Control and Prevention. http://www.cdc.gov/headsup/basics/concussion_whatis.html. Accessed Oct. 2, 2016.
  6. Head injury. American Academy of Pediatrics. http://www.healthychildren.org/English/health-issues/injuries-emergencies/Pages/Head-Injury.aspx. Accessed Oct. 2, 2016.
  7. Schutzman S. Minor head trauma in infants and children. http://www.uptodate.com/home. Accessed Oct. 2, 2016.
  8. Giza CC, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013;80:2250.
  9. McCrory P, et al. Consensus statement on concussion in sport: The 4th International Conference on Concussion in Sport held in Zurich, November 2012. Journal of Athletic Training. 2013;48:554.
  10. Leibson CL, et al. Incidence of traumatic brain injury across the full disease spectrum: A population-based medical record review study. Epidemiology. 2011;22:836.
  11. Olympia RB, et al. Return to learning after a concussion and compliance with recommendations for cognitive rest. Clinical Journal of Sports Medicine. 2015;26:115.
  12. Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 2, 2016.
  13. Brown AW (expert opinion). Mayo Clinic, Rochester, Minn. Oct. 21, 2016.
  14. Heads up: Facts for physicians about mild traumatic brain injury (MTBI). Centers for Disease Control and Prevention. http://www.cdc.gov/concussion/HeadsUp/physicians_tool_kit.html. Accessed Oct. 13, 2016.
  15. Prideaux CC (expert opinion). Mayo Clinic, Rochester, Minn. Nov. 1, 2016.
  16. Riggin, E. EPSi. Nov. 10, 2016