Concussion Tests: Types, Purpose, Preparation, Procedure, and Results

Concussions are a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. Health professionals use concussion tests to assess brain function and diagnose concussions. This article delves into the purpose of these tests, how to prepare for them, what they entail, and how to interpret their results.

Purpose of Concussion Tests

• Initial Assessment: Concussion tests are crucial for assessing the severity and impact of a head injury immediately after it occurs.
• Monitoring Recovery: They are used repeatedly over time to monitor a patient’s progress and recovery from a concussion.
• Guiding Return to Activities: The results help healthcare providers make informed decisions about when it is safe for a patient to return to normal activities, including sports, school, or work.

Preparation for Concussion Tests

• Medical History: It is important for patients to provide a detailed medical history, including any previous concussions or head injuries, which could influence both the testing and the interpretation of the results.
• Rest: Prior to undergoing some types of concussion tests, particularly cognitive tests, patients may be advised to ensure they are well-rested to avoid fatigue affecting their performance.
• Avoiding Certain Medications: Patients may need to avoid certain medications that could alter mental status or neurological function before the test.

Types of Concussion Tests

• Cognitive Testing: Assesses cognitive functions such as memory, concentration, and the ability to recall information quickly and accurately.
• Balance Testing: Evaluates physical coordination and balance, which can be affected by a concussion.
• Imaging Tests: Includes CT scans or MRIs to assess for physical damage to the brain.
• Symptom Evaluation: Involves assessing the severity and presence of symptoms commonly associated with concussions, such as headache, dizziness, and confusion.

Procedure of Concussion Tests

• Cognitive Tests:
  • Standardized Assessment of Concussion (SAC): Includes questions that test orientation, immediate memory, concentration, and delayed recall.
  • ImPACT Test: A computerized test that evaluates visual and verbal memory, processing speed, and reaction time.
• Balance Tests:
  • Balance Error Scoring System (BESS): Requires standing in various positions and evaluating balance under different conditions.
  • Sensory Organization Test (SOT): Conducted on a force plate that measures postural sway.
• Imaging:
  • CT Scan/MRI: Performed in a hospital or imaging center, typically only if there are concerns about more serious brain injury or if symptoms worsen.
• Symptom Evaluation:
  • Graded Symptom Checklist: Patients are asked to rate their current symptoms compared to normal in order to assess the severity of the concussion.

Normal Range and Results Interpretation

• Normal Results: In cognitive and balance tests, results are compared to either pre-injury baselines (if available) or normative data for age and demographic. Normal results typically match or exceed these comparisons.
• Abnormal Results:
  • Cognitive Deficits: Scores significantly lower than baseline or norms may indicate cognitive impairment due to concussion.
  • Balance Issues: Increased instability or errors during balance tests can indicate issues with motor control and vestibular function.
• Imaging Tests: Typically normal after a concussion, as concussions usually do not cause visible changes on CTs or MRIs. Any abnormal findings could indicate more severe brain injury.

Risks of Concussion Tests

• Cognitive and Balance Tests: These are generally safe and non-invasive with no significant physical risks, although they may be mentally or emotionally fatiguing.
• Imaging Tests:
  • CT Scan: Involves exposure to a small amount of radiation.
  • MRI: Very safe, but can be uncomfortable due to loud noises and confinement in the machine.

Concussion tests help in diagnosing and managing concussions. They provide essential information on various aspects of brain function that can be affected by head injuries. These tests help healthcare providers determine the severity of the concussion and make critical decisions about a patient’s recovery process and their safe return to daily activities.