“What is the best test for a concussion?”
My friend has a concussion. What is the best test for a concussion?
2 Answers
There's really no such thing as a "a test for a concussion." Put another way, a diagnosis of concussion is a so-called "clinical diagnosis" meaning a diagnosis made "at the bedside" [or in an office] based on the history of the event(s) ie the signs symptomos as they started and evolved over time, and the bedside (or office) physical examionation of the patient. The key features that lead toa diagnosis of concussion are (1) a closed head injury, and (2) a sudden and transient loss of consciousness, which may be followed by a period of confusion.
There are certainly tests that may be done in those circumstances, either in an ER or subsequently in a neurologist's office, that may show there's more going on than a mere concussion. For example, a CT study demonstrate bleeding inside the cranial cavity might indica that in addition to a concussdion the patient has suffered, for example, a subdural or epidural hematoma (a blood clot which exerts inward pressure on the brain, and which has to be removed either emergently or less-urgently), or a cerebral "contusion" which indicates actual bruising of the cerebral cortex.
In a "typical" concussion the CT and/or MRI are usually normal, and show no such additional pathology, and the exam usually shows little except confusion which gradually (sometimes quickly; sometimes not) clears up.
Thereno specific treatment for a concussion either, other than the passage of time, i.e. waiting out the expected improvement of the confusional phase.
Some people have a lengthy, delayed recovery after a concussion, a so-called post-concussive syndrome, w/ persisting headache, dizzyness, "brainfog", difficulty concentrating, etc. Usually this too resolves fully, though sometimes takes weeks-months.
There are certainly tests that may be done in those circumstances, either in an ER or subsequently in a neurologist's office, that may show there's more going on than a mere concussion. For example, a CT study demonstrate bleeding inside the cranial cavity might indica that in addition to a concussdion the patient has suffered, for example, a subdural or epidural hematoma (a blood clot which exerts inward pressure on the brain, and which has to be removed either emergently or less-urgently), or a cerebral "contusion" which indicates actual bruising of the cerebral cortex.
In a "typical" concussion the CT and/or MRI are usually normal, and show no such additional pathology, and the exam usually shows little except confusion which gradually (sometimes quickly; sometimes not) clears up.
Thereno specific treatment for a concussion either, other than the passage of time, i.e. waiting out the expected improvement of the confusional phase.
Some people have a lengthy, delayed recovery after a concussion, a so-called post-concussive syndrome, w/ persisting headache, dizzyness, "brainfog", difficulty concentrating, etc. Usually this too resolves fully, though sometimes takes weeks-months.
Rest to allow the brain to heal is best
