Diagnosing Mild Traumatic Brain Injury
Diagnostic Tests
In addition to direct observation, there are a number of diagnostic tests that can be used to assess the existence and/or severity of MTBI. They include:
- Neurological exam
- X-ray
- CT Scan
- MRI Scan
- Angiogram
Taking a Careful History
Close, careful history taking is essential in diagnosing MTBI. Questioning patients as to whether they have had an injury or accident is an important first step because some patients may not mention it to their physicians. For the following reasons careful history taking to ascertain the nature of the problem is very important.
- Some may not consider the injury serious because they were told the condition was mild or just a "bump on the head"
- Some may not realize they received a head injury because they were briefly unconscious at the time of the incident
- Some may focus on a more severe injury that occurred at the same time
- Some may be too embarrassed to mention certain symptoms, such as memory problems
Making a Diagnosis
MTBI diagnosis should be considered when one or more of the following conditions occur following a brain injury:
- Confusion or disorientation
- Amnesia near the time of the injury
- Loss of consciousness up to 30 minutes
- Neurological or neuropsychological problems
- Score of 13 or higher on the Glasgow Coma Scale (GCS)
In assessing patients for possible MTBI, it is important for physicians to determine whether there is any evidence that a brain or other intracranial injury is present or is likely to have occurred, especially among:
- Patients who did not see a physician after sustaining an injury
- Patients referred by an emergency department
- Patients facing orthopedic or facial trauma surgery
- Patients who did not receive follow-up care following admission to a hospital for an injury