Concussion Testing

A concussion occurs when there is an impact, either a direct or indirect jolt, bump, blow, or hit to the head causing cellular or chemical changes to the brain leading to brain trauma/injury that can as well affect its functions. It can be temporary or permanent, mild or severe, and can result in certain disorders such as recurrent headaches, lack of concentration, changes in mood, memory loss, etc.

People who are at risk of concussions include:

• Children
• Athletes especially those in high-impact sports such as American football, wrestling, boxing, etc.
• People involved in accidents.

If not diagnosed and treated early enough, a concussion can get worse (especially for those who can not heal quickly and if there are more impacts). Severe concussions can lead to severe brain damage. Hence the need for concussion testing.

WHAT IS CONCUSSION TESTING?

Concussion testing or “concussion assessment” is any form of tool or exercise that evaluates and determines the rate of trauma or injury done to the brain.

It can be in the form of questionnaires to rate the severity of the trauma according to the symptoms exhibited or scans or tests to search for the presence of brain trauma/injury (concussion) and evaluate the extent of the damage.

FORMS OF CONCUSSION TESTING

There are various forms of concussion assessment tools. Some of these forms work hand in hand to properly diagnose the condition. 

Concussion vital signs may include:

• Dizziness
• Headache
• Vomiting
• Reduced energy level (fatigue)
• Confusion 
• Changes in mood
• Changes in sleep pattern.
• Sensitivity to noise and light.
• Concentration problems
• Problems with memory
• Seizures
• Problem with balance
• Motion issues
• Distorted vision
• Speech slur
• The hearing difficulty, etc.

These forms are divided into two; cognitive tests and medical tests. They include:

• Cognitive Tests

These tests come in form of questionnaires. They rate brain trauma by assessing symptoms based on brain functions. Some of these tests include:

• Post Concussion Symptoms Scale (PCSS)

This test is a symptom ranking system for concussions. Here, the possible symptoms of concussions are ranked from the most severe to the least severe symptoms. The patient ticks according to the severity and this determines if a concussion has occurred.

• Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)

Impact concussion test diagnosis concussion by concentrating on the visual, verbal, vestibular, and balance processing problems of the brain. 

It evaluates to check the memory, processing speed, and reaction time and to find out if there are any problems as they occur in concussion. Impact testing online a computer determines how fast the brain’s function of concentration and processing can work because the time for the questionnaire and each question is preset.

• Standardized Concussion Assessment Tool (SCAT)

SCAT tests concussion by finding out symptoms of concussion-related to motor skills. There are two types:

• SCAT3

This tests for symptoms in coordination, balance, reflexes.

• SCAT5

This tests for symptoms related to coordination, balance, reflexes, energy, and movement.

• Medical Tests 

These tests involve imagery and normal tests used to diagnose a concussion. These tests are often used alongside cognitive tests to properly ascertain if the brain is concussed. They include:

• Concussion Eye Test (Pupil Test)

A concussion pupil test is a physical examination carried out by the doctor to check the eye-related symptoms of a concussion.

Using a flashlight, the doctor examines the eyes (pupils) for dilation or difference in sizes.

• Brain Trauma Indicator

This is an FDA-approved test to check for concussion in adults. This test checks and measures certain proteins that are released into the bloodstream a few hours after head impact, injury, or trauma which indicates concussion.

• Neurovascular Exam

This test examines the neurovascular areas of the brain to look out for problems connected with a concussion. It is often performed alongside the ImPACT test.

• Electroencephalogram (EEG)

This is used for brain wave monitoring and can evaluate brain injury or trauma.

• Computerized Tomography (CT) Scan

CT scan for concussion is a type of X-ray that takes images of the brain and can be used to check for brain trauma or injuries.

• Magnetic Resonance Imaging (MRI) Scan

This scan uses magnetic radio waves to create images of the brain and this can show if the brain is concussed.

For athletes, especially for high-impact sports, the cognitive tests are given as online questionnaires and are called “baseline concussion test” or “concussion baseline test”. This is given before they start their sports season. 

The baseline concussion test measures their memory, concentration, coordination, reflexes, balance, and others to check the possibility of a concussion. It is similar to playing a video game and takes about 15 minutes to complete. The test is a fast and efficient way of testing the athlete’s brain function and determining how fit and ready he/she is for the next season.

Also, you can perform concussion tests at home using the symptoms scaling system. It can be called “self concussion test” or “1-minute concussion test”. You can browse for concussion tests online.

PURPOSE OF CONCUSSION TESTING

Concussion assessment is performed for the following reasons:

1. To check for head injury or trauma.
2. To assess the cognitive functions of the brain.
3. To examine how well the brain is functioning and if the concussion has affected any brain function.
4. To check if the brain has recovered from an episode of concussion.
5. To determine the severity of a concussion and if treatment is necessary.

CONCUSSION TESTING PREPARATION

Concussion testing does not require special preparation especially cognitive tests. Cognitive tests are often performed with a computer.  All you have to do is sit before the computer and answer the question displayed for you.

For medical scans, you are to rid yourself of all jewelry before they begin. There might be medications that may be problematic for the scan, your doctor will advise you on them.

In the case of brain trauma indicator, there is hardly any chance to prepare because the test is done few hours after the brain trauma has occurred.

CONCUSSION TESTING PROCEDURES

Cognitive tests simply involve answering questions about vision, reflexes, motion, coordination, memory, concentration, balance, etc., in a computerized setting or online a computer.

For scans, you are laid straight on your back on a flat platform connected to the machines and strapped in. Then you are rolled in till your head is inside the machine. The machine scans your brain and takes images and this is done in under 10 to 15 minutes. After that, you can wait for the results.

For brain trauma indicator, 0 to 10 hours after the traumatic experience, which can be a fall, accident, or as a result of high-impact sports, your blood is drawn to test for certain proteins released after the trauma. Once the blood is drawn, it is taken to the lab and tested. This takes 20 to 30 minutes. After the tests, you are only required to wait for the results and your doctor can interpret and guide you on the next step to take.

For cognitive tests especially for concussion baseline tests, based on your performance, you may need to have other sessions of testing for few more weeks to conclude.

CONCUSSION TESTING RESULTS & AFTER-CARE

If the results show that you have a concussion, it is advisable to take a break from all strenuous activities and rest. Take time from every activity that will require using a lot of your brain. 

Limit reading, or engaging in physically or mentally challenging exercises. In the meantime, avoid televisions and computers, and limit the use of your phone. You are expected to sleep a lot as this gives your brain more time to heal.

As an athlete with a concussion, you are denied the chance to play till you fully recuperate. You will need to work with your doctor and trainer to assess your health condition. 

Subsequently, more tests are carried out called the “after-injury” tests to find out if your brain is healing up as it should and if its functions are restored.

FAQs

• What happens if a concussion is left untreated?

When a concussion is not taken care of in its early stages, it can worsen and lead to long-term complications. These may include:

• Chronic headaches
• Mood changes
• Vertigo
• Vision problems 
• Memory fog and loss
• Motion, balance, coordination, concentration difficulties.

 

• How is a concussion treated?

The first-line treatment for concussion is maximum rest. Abstain from physical and mental exercises. Stay away from sensitive lights and exercises that require concentration and thinking. Avoid watching TV, using a computer or phone during the time. Sleep a lot. This is advised for at least a week or when your doctor considers you good to go.

• How do you know a concussion is gone?

Your concussion is considered healed after an after-injury test has been conducted and you no more have symptoms of concussion and you have regained concentration, balance, memory, etc. You will also have to go through physically straining exercises such as sit-ups, jogging, etc to check if you are fully recovered.

• How do your eyes look when you have a concussion?

You will experience visual disturbances when you have a concussion. Mostly, your eyes will look dilated, with pupils bigger than normal or there will be differences in their sizes.

• How long does a mild concussion last?

To have a concussion, you need to apply treatment measures to recover fast. If you rest as recommended, recovery can take 1 to 2 weeks, but if you do not follow recommendations, they can last longer and even develop into “post-concussion syndrome”.