Concussion and the Confusion Around Diagnosis
MRI for concussion assessment is a standard diagnostic test often used to evaluate the severity of a head injury. Sadly, a concussion can leave you feeling “off” long after the injury, even when medical scans say you’re fine. This mismatch between symptoms and test results is common, but that doesn’t make it normal.
It’s frustrating to hear “your MRI is normal” while still suffering headaches, neck pain, dizziness, or brain fog. At this point in time, most patients usually feel written off by their medical providers, so it’s essential not to let this happen to you.
In this article, we’ll explore why MRI for concussion often doesn’t show the whole picture. More importantly, we will discuss what the next steps look like and how to find the appropriate care to address your symptoms.
Can MRI Detect a Concussion?
In most cases, MRI can’t directly detect a concussion—because a concussion is a functional injury, not a structural one. Standard MRI scans are designed to detect abnormalities such as bleeding, swelling, tumors, or fractures. Most mild to moderate concussions commonly disrupt brain function—how nerve cells communicate—not its anatomy.
Research also confirms this notion: Traditional MRI scans typically appear normal in mild traumatic brain injury (mTBI), also called concussion, since it reflects dysfunction rather than visible damage.
More advanced scans—such as diffusion MRI or functional MRI—sometimes reveal subtle changes; however, even these are primarily used in research settings rather than routine clinical care.
If your MRI or CT scan detects structural changes in the brain, your medical provider will immediately determine the best next steps.
When Is an MRI Recommended?
Though standard MRI for concussion isn’t diagnostic, doctors may still recommend it when they need to rule out structural injuries in the brain and body.
Signs that warrant imaging include:
- Severe or worsening headaches
- Loss of consciousness
- Seizures
- Persistent vomiting
- Numbness, weakness, slurred speech
- Balance problems
- Internal bleeding from the nose or ears
- Significant changes in vision
In these red flag situations, MRI is commonly used to detect bleeding, fractures, swelling, or other serious injuries. If you have no warning signs and only mild symptoms, monitoring recovery over time is often advised—but if symptoms persist beyond a few weeks, an MRI may be considered to rule out any hidden issues that warrant further investigation.
What MRI Can (and Can’t) Reveal About the Brain
What MRI can show:
- Obvious signs of injury: bleeding, fractures, swelling, tumors, or fluid buildup
- Rare structural lesions linked to more serious traumas or congenital anomalies
What MRI can’t show:
- The subtle shifts in brain function that cause persistent post-concussion symptoms
- Altered blood flow or real-time changes in the brain
- Standard MRI won’t reveal diffuse axonal injury or abnormal neural connectivity without using advanced techniques like DTI or fMRI
Advanced imaging, such as DTI (diffusion tensor imaging) and fMRI, offers insights into how brain wiring and connectivity may be affected. Studies show that DTI can detect microstructural changes in white matter, and functional MRI can identify connectivity alterations associated with symptoms.
But as we’ve stated, these tools remain primarily in the research domain—rarely available in standard clinical settings.
When “Normal MRI” Doesn’t Mean Normal Feelings
Receiving a “normal” MRI result can feel dismissive, but it’s essential to understand that normal imaging doesn’t mean your symptoms aren’t genuine. In post-concussion syndrome (PCS), MRI is mainly used to exclude structural damage—functional recovery pathways lie elsewhere.
If your symptoms persist after an MRI, that’s not a dead end. Instead, it means traditional imaging can’t capture what’s causing your brain to feel “off.” In medical research, advanced scans sometimes align with ongoing symptoms—such as memory trouble tracked via DTI in correlation with cognitive assessment scores.
More importantly, if you continue to experience symptoms after normal imaging, it’s essential to find highly experienced providers who can conduct a thorough examination to diagnose your condition accurately.
In our clinical experience at The Neural Connection, bedside structural examinations, paired with neurological testing and objectively measuring visual tracking, are the best way to find solutions. We often see those patients who have been told to “wait it out” and “sleep it off”, even after weeks, months, or years of trying to do so.
Advice for Patients Navigating Post‑Concussion Care
- Use MRI for concussion wisely. It’s excellent at ruling out serious injury—but not at confirming concussions. Don’t feel lost if your imaging comes back normal!
- If warning signs appear, trust your provider when they order an MRI to look for hidden harm.
- If MRI is normal but you’re still not yourself, you still need evaluations beyond imaging—like bedside structural examinations, neurological testing, and visual assessments.
- Advanced imaging may one day become more common, but currently, care focuses on managing symptoms, creating personalized therapy plans, and promoting functional rehabilitation.
Still Dealing With Post-Concussion Symptoms?
Experiencing persistent symptoms despite a “normal” MRI for concussion? You deserve tailored care that sees beyond imaging. Since every concussion heals at a different rate and timeline, it’s imperative to find the care you need immediately.
At The Neural Connection, our neurologic rehab clinic specializes in bridging the gap between objective scan results and how you feel.
Contact us today for a consultation focused on functional recovery and the path forward—not just test results.
Consultation Link
*Note: The information provided in this article is for educational purposes only and does not constitute a doctor-patient relationship. Patients should consult their medical provider or primary care physician before trying any remedies or therapies at home.
