Diagnosis

Your doctor will evaluate your signs and symptoms, review your medical history, and conduct a neurological examination. Signs and symptoms of a concussion may not appear until hours or days after the injury.

Tests your doctor may perform or recommend include a neurological examination, cognitive testing and imaging tests.

Neurological examination

After your doctor asks detailed questions about your injury, he or she may perform a neurological examination. This evaluation includes checking your:

• Vision
• Hearing
• Strength and sensation
• Balance
• Coordination
• Reflexes

Cognitive testing

Your doctor may conduct several tests to evaluate your thinking (cognitive) skills during a neurological examination. Testing may evaluate several factors, including your:

• Memory
• Concentration
• Ability to recall information

Imaging tests

Brain imaging may be recommended for some people with signs and symptoms such as severe headaches, seizures, repeated vomiting or symptoms that are becoming worse. Brain imaging may determine whether the injury is severe and has caused bleeding or swelling in the skull.

A cranial computerized tomography (CT) scan is the standard test in adults to assess the brain right after injury. A CT scan uses a series of X-rays to obtain cross-sectional images of your skull and brain.

For children with suspected concussion, CT scans are only used if there are specific criteria met, such as the type of injury or signs of a skull fracture. This is to avoid radiation exposure in young children.

Magnetic resonance imaging (MRI) may be used to identify changes in your brain or to diagnose complications that may occur after a concussion.

An MRI uses powerful magnets and radio waves to produce detailed images of your brain.

Observation

You may need to be hospitalized overnight for observation after a concussion.

If your doctor agrees that you may be observed at home, someone should stay with you and check on you for at least 24 hours to ensure that your symptoms aren't worsening.

Your caregiver may need to awaken you regularly to make sure you can awaken normally.