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Concussion Diagnosis: How Doctors Do It

September 27, 2022

Most times, diagnosing an injury can be simple.

Say your child falls off of his bike. He puts his arm out to break his fall, and now his wrist is hurting badly. You take him to the doctor’s office and they take an X-Ray. From the X-Ray, the doctor can be 100% sure that the bone is broken.  

Unfortunately, while diagnosing an injury such as a bone fracture is typically straight-forward, diagnosing a concussion can be much more challenging.

What Makes a Concussion Diagnosis So Difficult?

First, while an X-Ray can detect a broken bone, there is currently no diagnostic test for concussion

If you take your child to urgent care or the emergency department with a head injury, the medical providers there may perform some sort of scan – from a CT Scan to an MRI. 

A Computed Tomography (CT) Scan shows the provider whether a patient has sustained certain non-concussion injuries to the skull and brain (such as bleeding on the brain, skull fracture, or swelling on the brain). Meanwhile, a Magnetic Resonance Imaging (MRI) scan can give the provider a more specific view of brain tissue. However, neither an MRI nor a CT Scan are true diagnostic tests for a concussion.

Second, concussions can look very different from patient to patient. The list of possible concussion symptoms is long and wide-ranging. Some patients may have one or two symptoms, while others may have many. Also, symptoms cover broad categories such as physical pain (i.e. headache), energy levels (i.e. feeling extremely tired), cognitive (i.e. difficulty remembering), and emotional (i.e. feeling extra irritable).  

Third, a concussion does not have to result from a direct hit to the head. A concussion can occur as a result of a whiplash motion of the head, when the head and neck move forcefully. When there was no direct blow to the head, it is sometimes more difficult for patients and providers to link a patient’s concussion symptoms with an isolated whiplash event. 

Fourth, concussion symptoms may not begin immediately following a whiplash event or direct hit to the head. You and your child may notice symptoms hours – or even an entire day – after the injury occurs. It can be EVER MORE challenging for the provider and patient to make the connection between the event and the symptoms when there is a longer period when the patient feels fine prior to the onset of symptoms. 

New innovations in concussion detection – such a using biometric measures – are being investigated for the use of diagnosing concussions. However, until there is a proven and accepted diagnostic test, providers must use a multi-dimensional approach, measuring function (responses and actions) as a reflection of brain health and the presence of concussion.

Diagnosing a Concussion

When diagnosing a concussion, most health care providers use the multi-dimensional approach mentioned above. This means they will ask the patient to perform a variety of tasks and measure any deficits in performance. Some of these tasks may include:

  • Reaction Time
  • Balance
  • Blink Reflex
  • Processing Speed
  • Eye Movement
  • Memory
  • Head and Neck Movement
  • Walking Gait

Asking a patient to complete a variety of tasks – while assessing knowledge of their medical history (including baseline tests) and self-reported symptoms – can give a medical provider enough information to make an official diagnosis of concussion. This broad assessment can be used throughout the recovery period to ensure that the brain has fully healed. 

Although there is not currently a diagnostic test for concussion, using multiple measures of brain function and patient-reported symptoms remains the best way to make a concussion diagnosis.

When to Bring Your Child in For a Potential Concussion

If you are noticing any of the following symptoms, bring your child to the MOFMC Walk-in Clinic to check for a concussion:

  • Headache
  • Dizziness
  • Feeling in a fog
  • Feeling extremely tired
  • Difficulty focusing
  • Memory loss
  • Feeling extra irritable
  • Sensitivity to light or noise
  • Feeling emotional

REMEMBER, even if you are unsure when your child might have sustained a head injury, your child may still have a concussion. It is always better to bring your child to the clinic for a check-up just to be safe.

Mount Olive Family Medicine Center | Concussion Clinic

Think your child may have a concussion? Before scheduling an appointment with the Mount Olive Family Medicine Concussion Clinic, each patient must be diagnosed with a concussion either by their primary care provider, a provider at the Emergency Department, or by an MOFMC Walk-in Clinic provider. 

Once you have a diagnosis, set an appointment with our MOFMC Concussion Clinic by calling Dr. Long at 919-658-4954 ext. 1040.

Have more questions about our Concussion Clinic and resources? Visit our Concussion Clinic page or call us at 919-658-4954.


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