Q&A About Concussion Diagnosis and Evaluation
Parent 1: How would you diagnose a concussion?
Christina L. Master, MD: So despite all of our advances in medical technology, concussion is still a clinical diagnosis. It's important for the physician to pull the entire story together with the injury, the symptoms that developed after the injury, and then their physical exam and how your child looks right now.
Matthew Grady, MD: As part of the more in-depth concussion evaluation, we would do a physical exam. And that would include eye tracking and balance. These are commonly impaired with concussions. Additional testing, such as cognitive testing, which can include simply asking questions or asking to repeat digits forward and backwards as a way to get a sense for brain function, help us in making that diagnosis. There are no specific tests that prove you have a concussion.
Christina L. Master, MD: A CT and an MRI will not detect any signs of a concussion. What they're used for early on in the emergency room is to see if your child has a bleed in the brain, not to diagnose a concussion.
Matthew Grady, MD: There's no blood test for a concussion. There's no computerized test that will tell you if you have a concussion or not. A concussion occurs after you have a head trauma, followed by symptoms or deficits on physical exam. Each of those individual pieces is a piece of the puzzle. We have to put all the pieces of the puzzle together to make the clinical diagnosis of a concussion.
Parent 2: How do you know when a concussion is getting better?
Christina L. Master, MD: Sometimes children take longer than adults to get better. Certainly, there are some cases where kids can have a concussion and they can recover within a few days. But there are definitely many cases where kids can take longer. So you want to be ready for that, not just assume that they will have a short recovery.
Matthew Grady, MD: The concussion will get better when the symptoms start to improve. So we may say no school work, no text messaging, no video games immediately after the injury. As they start to get better, we'll add in school work. If they tolerate that well, that's a sign that their concussion is starting to improve.
Christina L. Master, MD: The other thing that you're looking for is making sure that they can tolerate full physical activity. If they have no symptoms and their physical exam in the office is completely normal, looking for the specific deficits that we know that we see in concussion, then they can be cleared for contact practice, and then after contact practice, they can go to contact play.
Topics Covered: Concussion
Related Centers and Programs: Concussion Care for Kids: Minds Matter