Learn about diagnostic evaluations of concussions and other brain injuries.
CT and MRI scans are the most common imaging modalities to evaluate people with traumatic brain injury, but advanced imaging methods are more promising for diagnosis and prognosis. However, interpretations of findings can vary.
We do not yet have a clear understanding of what happens in the brain immediately after a concussion and over the days and months that follow, especially for those patients whose symptoms persist. Post-concussion symptom rates vary greatly among research studies, likely because the populations studied are diverse and so are the diagnostic criteria and timing of assessments. The wide variation in symptom rates highlights the fact that there is a lot we still don’t know about concussions.
When we think of “youth” and “concussion,” the first thing that likely comes to mind is a teenager engaging in a high-risk activity such as football, soccer, or snowboarding. But not all youth brain injury results from these risky activities. Of the millions of concussions reported by emergency rooms every year, figures put concussions related to sports and recreation at just 30% – so 70% of concussions result from other causes.
Clinicians like me say that concussion requires a clinical diagnosis based on the history of what happened to produce the symptoms. However, because these same symptoms appear in other conditions, and we don’t have reliable biomarkers, diagnosing a concussion can sometimes be a challenge. The lingering effects of a mild brain injury can also continue as a chronic condition, often referred to as post-concussion syndrome or persistent post-concussion symptoms, that still require treatment.
A traumatic brain injury can be associated with depression or another mood disorder, possibly because of the disruption of brain chemicals.
Elizabeth Sandel, MD, a physiatrist and brain injury medicine physician, and Conor Gormally, co-founder of Concussion Alliance — a young man who has experienced several concussions — present a patient-centered care approach for emergency medicine and primary care physicians.
Although most children recover fully after a single concussion, others have long-term effects. Of course, prevention is the best strategy, but if a concussion occurs, parents must understand a brain injury has occurred.
Children can experience a range of symptoms after concussion. They require individualized treatments and strategies for returning to activities and to school. A physician with training and experience in treating concussions must provide early interventions and follow-up, regardless of how long recovery takes.
To properly diagnose a concussion and devise a treatment plan requires a thorough physician evaluation, a symptom checklist or an interview, or both, followed by a comprehensive cognitive and physical examination. Download a pocket guide that helps patients prepare for being evaluated.
Child abuse is a top cause of brain injury-related emergency room visits, hospitalizations, and deaths among children of all ages. Diagnosis can be challenging in cases of pediatric abusive head trauma. Prevention strategies at the individual and community level can be effective and there are many available resources.
What happens to the brain after a severe brain injury that renders a person unconscious or “comatose”? Learn the meaning of other terms that describe patients who have disorders of consciousness: the minimally conscious state, cognitive-motor dissociation, covert consciousness, and unresponsive wakefulness syndrome (vegetative state). Researchers are studying advanced technologies evaluating patients with disorders of consciousness, and there are new U.S. and European guidelines that are helping to standardize care and advance the field of brain injury.
Traumatic brain injuries are very common in older adults who fall. They can result in hospitalization, death, or disability especially in this age group and those on certain medications. In this post, an elderly woman has a delayed hematoma from an injury that could have been deadly. Falls can be prevented and Dr. Sandel shares important information about risk factors and tips for prevention.
Keep up to date
Get updates on the latest in concussion, brain health, and science-related tools from Dr. Elizabeth Sandel, M.D.