The Ultimate Guide to Concussion Tests for Patients – Essential Knowledge and Resources

Comprehensive concussion tests can be the key to receiving the necessary treatment instead of just the available options. Concussions are a significant health issue, especially for those participating in sports or activities that pose a risk of head injuries.

Recognizing and understanding concussion symptoms is vital for appropriate treatment and recovery, particularly in the initial days following an injury. This detailed guide will delve into each concussion test’s nuances, their importance, how they are conducted, and what patients can anticipate during and after the tests.

Additionally, we will cover how to find concussion assistance when it’s most needed, emphasizing the importance of immediate and personalized care for recovery.

Understanding Concussions: A Basic Overview

Concussions are a common form of mild traumatic brain injury resulting from a hit, bump, or jolt to the head. They can also occur when a body hit causes the brain to rapidly shear back and forth, such as in a fall on the ice or a car accident.

This abrupt movement can make the brain bounce, twist, and shear inside the skull, leading to neuroinflammatory and chemical changes in the brain and subsequent damage to brain cells.

Concussion Symptoms to Watch For

As a patient, it’s vital to recognize the signs and symptoms of a concussion. These symptoms can include the following:

• Headache
• Dizziness
• Nausea or vomiting
• Head and neck pain
• Sensitivity to light and noise
• Confusion or difficulty concentrating
• Blurred vision
• Fatigue
• Problems with memory or concentration
• Sleep disturbances or mood changes

What Are The Best Concussion Tests?

Concussion tests consist of several evaluations designed to determine if an individual has sustained a concussion. These tests assess different aspects of brain function, such as memory, concentration, balance, and physical symptoms.

They also examine vision and reaction times and may include blood chemistry panels. Concussion tests are essential tools for diagnosing and managing concussions to prevent further injury and ensure proper recovery.

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 it’s essential to understand what type you need to find the most effective treatment. 

This section below explores the different types of concussion testing currently available, each serving a unique purpose in evaluating and diagnosing these traumatic brain injuries.

Types of Concussion Tests

Physical Examination

One of the initial steps in concussion testing involves a comprehensive physical and orthopedic evaluation. Healthcare professionals check the individual’s vitals, including heart rate and blood pressure in supine, seated, and standing positions, as well as body temperature and respiration rate.

This part of the examination may also involve various cognitive and emotional tests as a baseline, depending on the symptoms presented.

A cervical spine examination will be conducted to check for any signs of tissue damage to the neck or surrounding spinal structures.

Lastly, a gait assessment may be performed to determine if the concussion has impacted your ability to walk and coordinate basic movements correctly.

These assessments collectively help determine the injury’s severity, rule out other potential causes, and gather crucial information to guide further diagnostic decisions.

Standardized tools like the Standardized Assessment of Concussion (SCAT) or Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) provide objective measures of cognitive performance, including memory, attention, and concentration.

These assessments establish a baseline for comparison and help track cognitive recovery progress over time. They are most effective when conducted before a concussion occurs, serving as a benchmark for post-injury function.

Balance Assessments

Evaluating balance control through tests such as the Romberg Test, tandem walk, or objective force plate analysis identifies any balance impairments resulting from concussions. These tests can objectively measure postural stability and determine the effectiveness of rehabilitation programs.

The BTrackS and CAPS systems are commonly used to objectively measure balance.

Autonomic Testing

Concussion specialists often use autonomic testing to assess imbalances between the two branches of the sympathetic and parasympathetic nervous systems. Common methods include tilt table testing, sit-to-stand testing, and more advanced specialty tests.

Dysfunction in these systems is typically labeled under the catch-all term “dysautonomia,” which often requires specialized testing for a specific diagnosis. Some patients may also be diagnosed with Postural Orthostatic Tachycardia Syndrome (POTS), depending on clinical findings and assessments.

Vestibular and Ocular Assessments

Vestibular and ocular dysfunctions often occur together 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 identifies abnormalities or imbalances in the vestibular system that contribute to dizziness and visual disturbances. VNG also provides an objective way to assess baseline function and track progress over time.

VOR Assessment

The Vestibulo-Ocular Reflex (VOR) test evaluates how well the vestibular system and eye muscles coordinate, identifying deficiencies in gaze stability and smooth eye movements. VOR testing determines the extent of vestibular impairment and guides appropriate treatment strategies. It also assesses whether vestibular and visual rehabilitation will be beneficial.

King Devick Test

The King Devick Test is a baseline test that assesses rapid eye movements, visual tracking, and saccadic eye movements. It involves quickly reading a series of numbers or symbols on a card while being timed. Any disruption or delay in reading the card may indicate impaired eye movements, suggesting a concussion. Baseline testing before a concussion can provide evidence of changes following a concussion or mild brain injury.

Smooth Pursuit Testing

In smooth pursuit testing, individuals follow a moving target using only their eyes. Abnormal, jerky, or erratic eye movements can indicate issues in the brain’s ability to coordinate smooth eye movements, potentially suggesting a concussion or other visual tracking problems. Patients may also report pain or dizziness during this test, providing further evidence of pursuit dysfunction.

Imaging Tests

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.

Imaging is important, but it will only show objective evidence of structural changes in the brain if the injury is severe enough. 

Commonly used imaging techniques include the following:

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. Most patients who have CT scans performed may have normal findings but still experience symptoms. 

Magnetic Resonance Imaging (MRI)

MRI scans use specific magnetic fields and radio waves to generate detailed brain structure images. They can help identify more subtle abnormalities, such as small bleeds or swelling. 

Like CT scans, they may not always detect the specific changes associated with mild concussions. Patients rarely have abnormal MRI findings with concussion symptoms, so don’t let that deter you from seeking appropriate treatment and care. 

Diffusion Tensor Imaging (DTI)

This type of imaging assesses the integrity of white matter tracts, measures water molecule diffusion, and detects subtle abnormalities not visible on traditional imaging methods. It can aid in the diagnosis, prognosis, and monitoring of concussions, leading to more targeted treatment strategies and better recovery outcomes. 

We need further studies for its widespread clinical application in the context of concussions. DTI studies can be costly, so most providers opt for MRIs and CTs as a first line of defense before sending patients out for treatment. 

How to Prepare for a Concussion Test

• Rest: Before the test, patients need to get adequate rest. These tests can take a lot of energy and focus to complete. 
• Avoid Stimulants: Patients should avoid caffeine, nicotine, and other stimulants before the test. These compounds can change or alter findings, which could lead you down a path of inappropriate treatments. 
• Honest Reporting: An accurate account of your symptoms and previous medical history is crucial for an accurate diagnosis. Providing as much detail as possible is essential, even when dealing with memory issues. If you have difficulty remembering information, it’s best to bring a partner or family member to help you. 

The Process of a Concussion Test

• Initial Consultation: The healthcare provider must take a detailed personal medical history and discuss the circumstances of the injury. They should also ask questions about activities of daily living (ADLs) to assess how the injury has impacted daily life. 
• Symptom Checklist: The patient will usually complete a symptom checklist. It may also be wise to provide an overview of symptoms that have changed and improved over time as your injury progresses. 
• Physical and Cognitive Assessments: The healthcare provider will perform a series of tests, as previously listed, to determine the extent of the injuries. 
• Follow-Up Tests: Follow-up tests may be necessary to monitor recovery and adjust the treatment plan. It just depends on the type and severity of injuries one acquires. 

What to Expect After Your Concussion Test

• Immediate Feedback: The healthcare provider will discuss the results and provide immediate feedback. As a patient, having someone there with you is crucial so you can remember what they say. You can also ask to record your report of findings for later listening and sharing with loved ones. 
• Treatment Plan: A personally tailored treatment plan will be developed based on the test results. Providers may also suggest follow-up assessments or a referral to a highly trained provider for treatments. 
• Monitoring Progress: Regular follow-up appointments will be set to monitor progress with the treating provider and your primary care provider.

Concussion Help and Finding the Right Support

Concussion help isn’t always straightforward. It can be frustrating, disheartening, and overwhelming. 

However, if you or someone you know has suffered a concussion, it’s essential to understand that you’re not alone on this journey. Many resources and forms of support are available, such as support groups, rehabilitation services, and educational materials. 

Patients should be treated like the individuals they are, which is why finding the right provider and support system is crucial. Finding a doctor who you can trust is also crucial for long-term recovery. 

Long-Term Effects and Concussion Recovery

While most people with concussions recover quickly, symptoms can last for days, weeks, or even longer. Sadly, many patients can experience post-concussion symptoms for months and even years. 

Long-term effects may include persistent headaches, sleep disturbances, dizziness, visual changes, digestive issues, memory problems, and difficulties with concentration and coordination. Since everyone is different, symptoms can present differently for each person. 

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 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 before suggesting follow-up care. 

The best next step for finding appropriate care is to find a board-certified functional neurology provider. The best ones will have comprehensive testing designed to assess most of the systems listed above. 

Their job is to understand the systems affected in detail and, if warranted, treat or refer a patient to the appropriate specialist based on findings. Their assessments should include visual, vestibular, cervical, cognitive, and emotional testing. 

Beginning your assessment process with a functional neurologist will save you time and money in the long run. It will also help you understand which systems drive your most problematic symptoms.

They will also look at underlying metabolic or hormonal factors that other doctors commonly overlook. 

You’re Not Alone

Concussions are serious, but recovery is possible with the right knowledge and care. Remember, if you’re dealing with a concussion, you’re not alone. There is a supportive community and a wealth of resources available to help you on your road to recovery.

If you still have questions about concussions, we’re here to assist you!

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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.