Diagnosis
Health care providers examine head trauma survivors to ensure that the injury is not a more severe medical emergency such as an intracranial hemorrhage. As with all head and neck injuries, assessment includes the "ABCs" (airway, breathing, circulation) and stabilization of the cervical spine. Cervical spine injury should be assumed in any athlete who is found to be unconscious after head or neck injury. Maintaining adequate cervical stabilization is critical until neurologic function in all four limbs is found to be intact and the athlete has no reported neck pain or cervical tenderness on palpation. If qualified medical personnel is not available on the field, the athlete should be transport to an emergency facility. Indications that screening for more serious injury is needed include worsening of symptoms such as headache, persistent vomiting, increasing disorientation or a deteriorating level of consciousness, seizures, and unequal pupil size. People with such symptoms, or who are at higher risk for a more serious brain injury, are CT scanned to detect brain lesions and are frequently observed for 24 – 48 hours.
Diagnosis of MTBI is based on physical and neurological exams, duration of unconsciousness (usually less than 30 minutes) and post-traumatic amnesia (PTA; usually less than 24 hours), and the Glasgow Coma Scale (MTBI sufferers have scores of 13 to 15). Neuropsychological tests exist to measure cognitive function, the international consensus meeting in Zurich recommend the use of the SCAT2. The tests may be administered hours, days, or weeks after the injury, or at different times to determine whether there is a trend in the patient's condition. Athletes may be tested before a sports season begins to provide a baseline neurocognitive test for comparison in the event of an injury, though it may not reduce risk or effect return to play.
If the Glasgow Coma Scale is less than 15 at two hours or less than 14 at any time a CT is recommended. In addition, they may be more likely to perform a CT scan on people who would be difficult to observe after discharge or those who are intoxicated, at risk for bleeding, older than 60, or younger than 16. Most concussions cannot be detected with MRI or CT scans. However, changes have been reported to show up on MRI and SPECT imaging in concussed people with normal CT scans, and post-concussion syndrome may be associated with abnormalities visible on SPECT and PET scans. Mild head injury may or may not produce abnormal EEG readings.
Concussion may be under-diagnosed. The lack of the highly noticeable signs and symptoms that are frequently present in other forms of head injury could lead clinicians to miss the injury, and athletes may cover up their injuries to remain in the competition. A retrospective survey in 2005 found that more than 88% of concussions go unrecognized.
Diagnosis of concussion can be complicated because it shares symptoms with other conditions. For example, post-concussion symptoms such as cognitive problems may be misattributed to brain injury when they are in fact due to post-traumatic stress disorder (PTSD).
In 2011, the Georgia Tech Research Institute researchers are investigating the use of radar as a possible concussion detection tool. No clinic studies have been done to prove it is accurate, therefore currently not ready for use.
Read more about this topic: Concussion