Diagnostics

Concussions do not show up on CT or MRI scans, so these scans are not typically ordered by doctors. Doctors use a range of assessment tests to check for concussion symptoms related to cognition, memory, balance, visual processing, and more.

No CT or MRI scans for Concussions

Currently, whether you go to an emergency room (ER) or a doctor's clinic, there is no diagnostic tool available to test if you have a concussion. A CT or MRI will be ordered only if the doctor suspects bleeding in the brain or another type of more severe head injury.

Diagnostic Tools Used in Research

Researchers are using multiple types of diagnostic tools to measure physiological changes after a concussion. In the future, some of these tools may be available to patients at clinics and the emergency room. These diagnostic tools include functional MRI (fMRI), diffusion tensor imaging (DTI), magnetic resonance spectroscopy (MRS), cerebral blood flow (CBF), electrophysiology, fluid biomarkers, and transcranial magnetic stimulation (TMS).

Diagnostic Assessments used by Concussion Specialists

While an initial evaluation of a concussion may take place in an emergency room or doctor’s office, it's recommended that a patient follow up with a concussion specialist for a more comprehensive examination. An experienced, qualified physician will:

  • Ask about your current symptoms, including levels of pain and fatigue.

  • Assess your cognitive function, such as memory and attention.

  • Assess your mood after the injury, such as anxiety or depressive episodes. They will also ask about your emotions and moods before the injury.

  • Assess if your sleep has been affected by your injury.

  • Examine your neck to see if there is related dysfunction or injury.

  • Assess your vision, including focusing and visual tracking.

  • Assess your balance and how you walk (gait), and whether you have dizziness or other dysfunction related to the vestibular system.

  • Ask whether you have had prior concussions.

  • Ask whether you have seen improvement or deterioration since the time of injury. The physician may seek additional information from parents, coaches, teammates, and eyewitnesses to the injury.

  • Determine if there is an immediate need for neuroimaging to exclude a more severe brain injury — this would typically be a CT or an MRI.

This article details the many clinical examination tools that healthcare providers may use to diagnose a concussion.

Your brain may not be fully healed when the doctor's clinical assessment shows that all your symptoms have cleared up

Multiple research studies suggest that physiological problems from a concussion may last longer than any of the clinical diagnostic measures can detect. In other words, your doctor may run you through follow-up tests for memory, balance, etc., and say you are healed from the concussion when in fact you are not yet healed. Researchers are promoting the idea of " a ‘buffer zone’ of gradually increasing activity before full contact risk."