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)
measure of exercise performance
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 which would include:
A medical assessment including a comprehensive history and detailed neurological examination including a thorough assessment of mental status, cognitive functioning, sleep/wake disturbance, ocular (visual) function, vestibular function, gait and balance.
Determination of the clinical status of the patient, including whether there has been improvement or deterioration since the time of injury. This may involve seeking additional information from parents, coaches, teammates and eyewitnesses to the injury.
Determination of the need for emergent (as soon as possible) neuroimaging to exclude a more severe brain injury (eg, structural abnormality).
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."