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Tests and diagnosis
By Mayo Clinic staffDiagnosing a concussion is usually straightforward. If a blow to your head has knocked you out or left you dazed, you've had a concussion. It's more difficult, however, to determine whether the blow has caused potentially serious bleeding or swelling in your skull. Signs and symptoms of these injuries may not appear until hours or days after the injury.
After your doctor asks detailed questions about your accident, he or she may perform a neurological exam. This evaluation includes checking your:
- Memory and concentration
- Vision
- Hearing
- Balance
- Coordination
- Reflexes
A computerized tomography (CT) scan is the standard test to assess postconcussion damage. A CT scanner takes multiple cross-sectional X-rays and combines all the resulting images to produce detailed, two-dimensional images of your skull and brain. During the procedure, you lie still on a table that slides through a large, doughnut-shaped X-ray machine. The scan is painless and generally takes less than 10 minutes.
Not every concussion requires a CT scan, but the test is usually done as a precaution if there's a chance your injury is more severe than your immediate condition suggests. You're more likely to need a scan if you:
- Are age 65 or older
- Fell from a height of more than 3 feet (1 meter)
- Had a motor vehicle crash
- Are under the influence of alcohol or drugs
- Are unable to recall the accident for at least 30 minutes after it occurred
- Have persistent trouble with short-term memory — that is, retaining new information — after you've completely regained consciousness
- Vomited
- Had a seizure
- Suffered bruises, scrapes or cuts on your head and neck
- Fractured your skull
You may need to be hospitalized overnight for observation after a concussion. If your doctor says it's OK for you to be observed at home, someone should check on you periodically for at least 24 hours. You may need to be awakened every two hours to make sure you can be roused to normal consciousness.
- Minor head injury. American Academy of Pediatrics. http://www.aap.org/publiced/BR_HeadInjury.htm. Accessed Feb. 12, 2009.
- Heegaard WG, et al. System injuries. In: Marx JA, et al., eds. Marx: Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. St. Louis, Mo.: Mosby; 2006:349.
- Concussion. http://www.merck.com/mmhe/sec06/ch087/ch087c.html. Accessed Jan. 15, 2009.
- Evans RW. Concussion and mild traumatic brain injury. http://www.uptodate.com/home/index.html. Accessed Jan. 15, 2009.
- Living with brain injury. Brain Injury Association of America. http://www.biausa.org/education.htm#concussion. Accessed Feb. 15, 2009.
- Evans RW, et al. Traumatic disorders. In: Goetz GD. Textbook of Clinical Neurology. 3rd ed. Philadelphia, Pa.: W.B. Saunders; 2007:1185.
- Concussion. American Association of Neurological Surgeons. http://www.neurosurgerytoday.org/what/patient_e/concussion.asp. Accessed Jan. 15, 2009.
- DePompolo RW (expert opinion). Mayo Clinic, Rochester, Minn. Feb. 3, 2009.
