What To Look For in a Comprehensive Concussion Test

Concussions are complex and often require a multifaceted approach for accurate diagnosis and effective management. Healthcare professionals use various forms of concussion testing, and its important to understand what type you need in order to find the most effective treatment. In this comprehensive guide, we will explore the different types of concussion testing available, each serving a unique purpose in evaluating and diagnosing these traumatic brain injuries.

Concussion Test: Physical 

One of the initial steps in concussion testing involves a thorough physical evaluation. Healthcare professionals assess the individual’s vitals, including heart rate and blood pressure in seated and standing positions, body temperature, and respiration rate. This portion of the exam may include administering various cognitive and emotional tests as a baseline.

The cervical spine will also be examined to determine if there is any indication of tissue damage to the neck or surrounding structures. Lastly, you may perform a gait assessment to determine whether or not the concussion affected your ability to walk and coordinate basic movements correctly. Collectively, these assessments aid in assessing the severity of the injury, ruling out other potential causes, and gathering essential information to guide further diagnostic decisions.

Concussion Test: Neurological

Neurological examinations play a crucial role in evaluating concussions objectively. Several tests commonly assess brain function. 

Cognitive Assessment Tools

Standardized assessment tools like the Standardized Assessment of Concussion (SCAT) or Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) provide an objective measure of cognitive performance, including memory, attention, and concentration. These assessments establish a baseline for comparison and aid in tracking cognitive recovery progress over time.

Balance Assessments

Evaluating balance control through tests such as the Romberg Test, tandem walk, or force plate analysis helps identify any balance impairments resulting from concussions. These tests can objectively measure postural stability and aid in determining the effectiveness of rehabilitation programs. The BTrackS and CAPS systems are commonly used to objectively measure balance.

Autonomic Testing

The medical community commonly uses autonomic testing to assess whether there is an imbalance in the sympathetic and parasympathetic nervous system. It commonly uses tilt table testing, sit-to-stand testing, and more advanced specialty tests to assess this system. The medical community commonly labels dysfunction under the catch-all term “dysautonomia” and usually requires more specialized testing to obtain a specific diagnosis.

The Buffalo Concussion Treadmill Test is used to evaluate individuals recovering from concussions by monitoring their heart rate, blood pressure, and symptoms while walking or jogging on a treadmill. It helps determine when it’s safe for the individual to return to normal activities by assessing their response to increased physical exertion.

Vestibular and Ocular Assessments

Vestibular and ocular dysfunction are joint in concussions. Specific tests to evaluate these areas include: 

– VNG Testing: Video Nystagmography (VNG) assesses eye movements, focusing on the relationship between the eyes, inner ear, and vestibular system. It can identify abnormalities or imbalances in the vestibular system that contribute to dizziness and visual disturbances.

– VOR Assessment: The Vestibulo-Ocular Reflex (VOR) test evaluates how well the vestibular system and eye muscles work together, helping to identify any deficiencies in gaze stability and smooth eye movements. VOR testing aids in determining the extent of vestibular impairment and guides appropriate treatment strategies.

-King Devick Test: This test assesses rapid eye movements, visual tracking, and saccadic eye movements. The KD test involves quickly reading a series of numbers or symbols on a card while timed. Any disruption or delay in reading the card may indicate impaired eye movements, which can indicate a concussion.

-Smooth Pursuit Testing commonly evaluates eye movements post concussion. In smooth pursuit testing, individuals are asked to watch and follow a moving target with their eyes only. During this test, abnormal jerky or erratic eye movements can indicate a problem in the brain’s ability to coordinate smooth eye movements, potentially suggesting a concussion or other visual tracking issues.

Concussion Test: Imaging

While imaging studies are not always necessary for diagnosing mild concussions, they play a role in ruling out other potential head injuries or detecting more severe brain abnormalities. Commonly used imaging techniques include:

– Computed Tomography (CT): CT scans utilize X-rays to provide detailed brain images. They are valuable for identifying fractures, bleeding, or other structural abnormalities. However, CT scans may not reveal subtle changes associated with mild concussions.

-X-rays are not typically necessary to diagnose concussions.  However, doctors may use them in specific cases to rule out other head injuries or assess for skull fractures. Most concussions do not show visible damage on x-rays, which primarily provide detailed images of the skull to identify fractures or foreign objects. Diagnosis is usually based on clinical evaluation, reported symptoms, and neurological function assessment, with imaging studies considered based on symptom severity and risk factors.

– Magnetic Resonance Imaging (MRI): MRI scans use magnetic fields and radio waves to generate detailed images of the brain’s structure. They assist in identifying more subtle abnormalities, such as small bleeds or swelling. Like CT scans, they may not always detect the specific changes associated with mild concussions.

Diffusion Tensor Imaging (DTI) is an advanced neuroimaging technique for evaluating concussions. It assesses the integrity of white matter tracts, measures water molecule diffusion, and detects subtle abnormalities not visible on traditional imaging methods. DTI can aid in the diagnosis, prognosis, and monitoring of concussions. This leads to more targeted treatment strategies and better recovery outcomes. However, further studies are needed for its widespread clinical application in the context of concussions.

Where to Get A Comprehensive Concussion Test

One of the challenging aspects of concussion testing is that it’s rare for a single location to provide all of the tests listed above. As a general rule of thumb, start by ensuring you are safe and that nothing is imminently dangerous. A medical doctor is an excellent first point of contact regarding your immediate safety. They may perform imaging and run basic labs to rule out life threatening factors.

After you’re cleared for safety, a good functional neurology provider is the best next step. Most will have comprehensive testing designed to assess a majority of the systems listed above. Their job is to get a big-picture understanding of the systems affected and treat or refer them to the appropriate specialist based on findings. Their assessments should include visual, vestibular, cervical, cognitive, and emotional testing. Beginning your assessment process here will save you time and money. It will help you understand which systems are driving your most problematic symptoms. Click here to connect with a doctor at The Neural Connection to see if this testing is proper for you.

Conclusion

Concussion tests range from physical assessments and neurological examinations to vestibular and ocular evaluations and imaging studies. Each type of testing provides unique insights into different aspects of concussion-related symptoms and impairments. This comprehensive approach ensures proper evaluation, diagnosis, and personalized treatment plans for individuals recovering from concussions. As a rule of thumb, start by ruling out serious complications, then consult with a functional neurology provider. They’ll be able to assess the full picture and help guide you to the most appropriate form of therapy based on all the systems involved in your presentation. 

Testimonials

If you want to know more, look at the 81+ 5-star Google Reviews we’ve acquired to get an idea about how we can help with concussion recovery. The following is a review from a patient with chronic concussion problems. 

“After suffering a mild TBI from an accident I was having constant brain fog, processing, memory recall issues, anxiety, balance problems, and light sensitivity. After going to multiple doctors and clinics with little to no success or results, I was completely fed up and felt like nobody in the medical community understood or cared about what I was going through!

I was extremely lucky to find Dr Thompson Maesaka and finally found someone who cared enough to listen and actually explain what was wrong with me and how to fix it! The personalized rehabilitation program that he has you do actually works and has significantly improved my quality of life.

If you feel like you have hit a dead end with your cognitive issues come here! You won’t regret it!”

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*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients are advised to consult their medical provider or primary care physician before trying any remedies or therapies at home.