Overview

Concussion testing assesses your brain function before and after a head trauma. The tests are done by a doctor or other health care professional with expertise in evaluating and treating people with concussions. They measure physical skills such as balance, and mental skills such as memory, concentration, how quickly you can think and solve problems, and your ability to pay attention.

Concussion testing is one of the tools doctors may use to evaluate and manage your health after a head injury. People who are at risk of concussion may need baseline tests. Athletes may have these baseline tests at the beginning of the sports season. If you have a concussion test after a head injury, your doctor may compare your results to your test results before the head injury to look for changes.

Read more about concussions.

Why it's done

Concussion testing evaluates your brain's processing and thinking (cognitive) function after a head injury. A baseline concussion test may be performed before a sports season starts for athletes at risk of head injuries.

A baseline concussion test shows how well your brain is currently functioning and may be useful in diagnosing a concussion after an injury. A doctor may perform the test by asking questions, or testing may be done via computer.

This test may be repeated often, especially in younger athletes (usually age 10 and older) whose brains develop and change over time. Some athletes may need a baseline concussion test each year, with neuropsychological testing more often if they've had a concussion or have another medical condition.

After a concussion, testing may be repeated and compared to the previous test to look for any changes in your brain function. It can also be used as a guide to determine when the brain has recovered from a concussion.

Risks after a concussion

If you continue to play or return to play too early after a concussion, there is a significant risk of another concussion. A second concussion sustained while the initial concussion is healing can result in fatal brain swelling (second impact syndrome).

Repeat concussions can take longer to heal. Also, repeat concussions have a higher risk of causing permanent nervous system (neurological) damage.

Children, teens and female athletes may be at a higher risk of concussions than are others, and their recovery may be longer.

Individuals who have had a concussion should not return to play or activities until all symptoms are gone and they have been seen by a doctor or other health care professional with expertise in evaluating and treating people with concussions.

After concussion symptoms resolve and prior to returning to a sport or activity, people with concussions need to participate in a gradually progressive concussion exertional protocol, which usually lasts five to six days. Each day provides exercise that's progressively more challenging in exertion and intensity. Individuals must complete all levels without symptoms recurring to be cleared to return to sport and physical activity.

What you can expect

Before a concussion

You may need a baseline concussion test before the sports season starts. A baseline concussion test is often performed using a computer. The computerized test is similar to playing a video game.

Computerized baseline concussion testing offers a fast, efficient way for many athletes to test their baseline brain function. The testing takes about 15 minutes to complete.

After a concussion

You may have another computerized concussion test after a concussion. Depending on your performance on the computerized test and comparison to baseline testing (if available), you may repeat the test several times for up to a few weeks.

You may have a physical examination and testing to check for problems with balance, which may indicate a concussion. The computerized or pencil-and-paper concussion tests check for problems with thinking and memory. You may be tested to determine how quickly you can answer a question or solve a problem, your ability to remember things, and how well you can concentrate and pay attention.

Concussion tests are one of the tools to help doctors determine when your brain function has returned to normal. Doctors may use this along with other tests to decide when you may be able to safely resume normal activities.

Results

Returning to play

If tests show that your brain function has returned to normal but you're still experiencing symptoms of your concussion, then doctors will advise you not to return to sports until your symptoms are gone. Although many concussions resolve quickly, some athletes may experience symptoms for weeks, months or longer.

Doctors will also review your history and symptoms and perform a neurological examination to test your balance and other brain functions. If your concussion symptoms do not resolve, a doctor trained in brain and mental health conditions (neuropsychologist) may perform more-detailed testing to further assess changes in brain function.

Your treatment team will determine when you're able to return to sports, school and other activities.

Concussion testing care at Mayo Clinic

May 31, 2019
  1. Meehan WP, et al. Concussion in children and adolescents. https://www.uptodate.com/contents/search. Accessed April 18, 2019.
  2. Evans RW. Acute mild traumatic brain injury (concussion) in adults. https://www.uptodate.com/contents/search. Accessed April 18, 2019.
  3. Halstead ME, et al. Sport-related concussion in children and adolescents. Pediatrics. 2018;142:e20183074.
  4. 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.
  5. FAQs about baseline concussion testing. Centers for Disease Control and Prevention. https://www.cdc.gov/headsup/basics/baseline_testing.html. Accessed April 18, 2019.
  6. Smith AM, et al. Proceedings from the Ice Hockey Summit III: Action on concussion. Current Sports Medicine Reports. 2019;18:23
  7. Laskowski ER (expert opinion). Mayo Clinic, Rochester, Minn. May 6, 2019.