Getting a CT scan for a concussion can be scary but necessary. Sadly, concussions are one of the most common forms of traumatic brain injuries (TBI), affecting people of all ages.
They can occur during sports activities, car accidents, falls, or any incident where the head or body sustains a sudden impact. A concussion disrupts normal brain function, leading to symptoms such as headaches, dizziness, memory loss, sleep disturbances, and confusion.
One of the primary diagnostic tools often discussed for evaluating injuries to the brain is the CT scan for concussion. This imaging technique can help detect structural damage in the brain that could result from a head injury.
In this article, we’ll explore the role of concussion and CT scans in diagnosing and managing head trauma, explaining when a CT scan is necessary, its benefits, limitations, and alternatives.
What is a Concussion?
A concussion is considered a mild traumatic brain injury. It can be caused by a jolt or hit to the head or body, resulting in the brain rapidly twisting back and forth within the skull. This movement can lead to physical, neurological, and chemical changes in the brain.
Concussions can often lead to damage to brain cells and their membranes as well. While concussions are considered mild, they should not be taken lightly. They can still cause significant cognitive, physical, emotional, and metabolic symptoms that can impact a person’s quality of life.
Common Concussion Symptoms
Concussion symptoms can present in many different forms depending on the severity of the injury. Common symptoms include:
- Headaches
- Neck pain
- Confusion or “foggy” thinking
- Memory problems
- Dizziness or balance issues
- Sensitivity to light and noise
- Fatigue
- Altered sleep
- Nausea or vomiting
- Temporary loss of consciousness (in some cases)
While symptoms may appear immediately after the injury, others may develop over hours, days, and weeks later. If any of these symptoms are present after a head injury or fall, you should seek medical attention to determine if a CT scan for concussion assessment is necessary.
CT Scan for Concussion: What It Is and How It Works
A CT scan for concussion refers to using a computed tomography (CT) scan to evaluate the potential for brain injuries. CT scans use X-rays to create detailed cross-sectional images of the brain. These images help doctors identify abnormalities that may require immediate intervention, such as bleeding (hemorrhages), swelling, or fractures.
When Is a CT Scan Recommended for a Concussion?
Not all concussions require a CT scan. In fact, most concussions are considered mild and do not result in structural brain damage detectable by a CT scan. However, a concussion and CT scan may become necessary when a person exhibits specific symptoms that suggest a more serious injury. These symptoms include:
- Prolonged loss of consciousness
- Severe or worsening headaches
- Repeated vomiting
- Seizures
- Slurred speech
- Significant confusion or disorientation
- Weakness or numbness in the limbs
- Visible skull fracture or major facial injury
- Facial drooping
- Excessive bleeding from the head, nose, or ears.
If any of these “red flag” symptoms are present, a CT scan is crucial for ruling out life-threatening conditions like brain hemorrhages or skull fractures.
The Role of CT Scans in Diagnosing Concussions
While CT scans for concussions are invaluable in identifying acute injuries like internal brain bleeding or fractures, they are less effective in diagnosing concussions themselves. Concussions involve changes in brain function that are often microscopic and cannot be detected through imaging.
The CT scan’s primary function in this context is to rule out more severe injuries rather than to confirm a concussion diagnosis.
Doctors typically rely on clinical bedside evaluations, including cognitive tests, an in-depth neurological examination, and symptom assessments, to diagnose concussions.
However, a concussion and CT scan commonly go together to ensure that any potentially dangerous complications are identified early, especially if providers have no patient history when a patient enters a hospital.
Limitations of CT Scans for Concussions
Although CT scans are a powerful diagnostic tool, they do have limitations, primarily when used for concussion diagnosis:
Radiation Exposure
CT scans can expose patients to ionizing radiation, which can affect their health. While the risk from a single scan is low, repeated scans can increase the cumulative risk of radiation-induced conditions, particularly in children and young adults.
Lack of Sensitivity for Functional Injuries
As mentioned earlier, CT scans are excellent at detecting structural damage. Sadly, they are not sensitive enough to detect functional brain injuries, which are the hallmarks of concussions. Many concussions result in no visible changes on a CT scan.
Just because you’ve had a normal CT scan doesn’t mean your symptoms aren’t real. If you’re dealing with symptoms, it’s imperative to get an evaluation performed by a medical neurologist or Functional Neurologist.
Most patients who seek care for their post-concussion symptoms are in this situation, yet many think they’re fine because nothing showed up on their imaging.
Cost and Accessibility
CT scans are more expensive than other diagnostic tools like MRI and may not be available immediately in all medical settings. This lack of availability could delay diagnosis in some cases.
Alternatives to CT Scans for Concussion
While CT scans are often the first imaging modality used in emergency settings, they are not the only option. Tests like Magnetic Resonance Imaging (MRI) and functional MRI (fMRI) may gather more detailed information about the brain’s function and structure.
Once again, imaging can only provide information about the brain’s structure, not function. While it’s phenomenal for ruling out brain bleeding, tumors, and fractures, it’s not sensitive enough to assess functional changes in the brain. Concussions often create functional changes and microdamage that cannot be seen via diagnostic testing.
MRI vs. CT Scan for Concussion
MRI uses strong magnetic fields and various forms of radio waves to create detailed brain images. Unlike CT scans, MRI does not use ionizing radiation and can provide more precise images of soft tissues. MRI is more suitable for detecting subtle changes in brain tissue that may not be visible on a CT scan.
However, MRI is rarely the first line of investigation for concussions in emergency settings. MRI scans take longer to perform, are more expensive, and may not be as readily available. They are generally for patients who continue to have symptoms after a normal CT scan or those with more complex cases of head trauma.
Concussion and CT Scan in Children
Children and adolescents are particularly vulnerable to concussions, especially in sports, playing on playgrounds, and recreational activities. Diagnosing concussions in children and adolescents can be challenging, as their symptoms may not always align with those seen in adults. Moreover, their developing brains are more sensitive to the effects of radiation, making the use of CT scans for concussion more cautious.
Pediatric guidelines recommend against routine CT scans for children with mild head injuries due to the risks associated with radiation. Instead, doctors often use clinical criteria like the Pediatric Emergency Care Applied Research Network (PECARN) guidelines to decide whether a CT scan is warranted. This rule helps identify children at very low risk of clinically significant traumatic brain injuries, allowing physicians to avoid unnecessary scans.
Recovery from Concussions
Recovery from a concussion involves both physical and cognitive rest in the initial phase. Most people recover fully within a few weeks, but some individuals may experience post-concussion syndrome, where symptoms persist for months or even longer.
During recovery, it’s essential to avoid activities that could result in another head injury, as repeated concussions can lead to more severe long-term consequences.
Evidence shows that low-grade cardiovascular activity like walking is the best way to start rehabilitation after a week of rest. Census protocols like the Buffalo Concussion Treadmill Test (BCTT) to assess heart rate and aerobic capacity can help patients, providers, and parents understand how to move an individual into the early stages of rehabilitation and recovery.
Prevention of Concussions
Prevention is always better than treatment, and while concussions are unpredictable, the following steps can help reduce the risk:
- Wear protective gear: Individuals should always wear appropriate protective headgear to decrease the risk of head injuries while playing sports and recreational activities. These don’t necessarily “prevent” concussions, but they can protect the skull and face from further injury.
- Ensure safe environments: Ensure homes, workplaces, and sports fields are free of hazards that could cause falls or collisions. While easier said than done, an ounce of prevention may be worth a pound of cure or more.
- Practice proper techniques: In contact sports, ensure that players receive safe training that minimizes the risk of head injuries.
- Education: It’s important to educate coaches, parents, and athletes about the signs and symptoms of concussions. They must also understand the importance of seeking prompt medical attention. Seeking appropriate care immediately is one of the best ways to improve outcomes for patients and athletes who sustain concussions.
Frequently Asked Questions (FAQs)
Is a CT scan always necessary for a concussion?
No, a CT scan is not always necessary for a concussion. Most mild concussions do not require imaging unless there are “red flag” symptoms that suggest a more severe injury, such as prolonged unconsciousness, severe headache, vomiting, or neurological deficits.
How long after a concussion can a CT scan detect damage?
A CT scan can detect structural damage, such as bleeding or fractures, immediately after the injury. However, it is not typically used to detect the microscopic functional changes in the brain caused by a concussion. Once again, these changes are rarely visible on CT images.
What are the most common risks associated with a CT scan?
The primary risk of performing a CT scan is exposure to ionizing radiation. While the risk is low from a single scan, repeated scans can increase the cumulative exposure. This radiation exposure is primarily a concern for children and young adults.
Can a CT scan show a concussion?
No, a CT scan cannot show a concussion itself because concussions involve functional brain injuries that do not appear on imaging. CT scans can rule out other serious brain injuries, such as bleeding or skull fractures.
Are there alternatives to CT scans for concussion diagnosis?
Yes, alternatives such as MRI or bedside clinical evaluations are valuable when a CT scan is insufficient. MRI is more detailed for soft tissue imaging but is not usually the first choice in emergency settings due to its cost and time requirements.
How can concussions be prevented?
Wearing protective gear during sports and ensuring safe environments can increase prevention. Proper techniques in contact sports and increased education on concussion symptoms and risks can also help. While there is no proper way to prevent a concussion, these steps will reduce the chance of it happening.
Concussion and CT Scan: Is It Necessary?
The relationship between concussion and CT scan is vital in emergency, neurological, and rehabilitative medicine. While CT scans play an essential role in ruling out serious brain injuries, providers rarely use them to diagnose concussions directly. For patients with mild concussions, clinical bedside neurological and orthopedic evaluations remain the primary diagnostic method.
As understanding of head injuries evolves, safer and more precise diagnostic tools will develop to improve patient outcomes. Whether through a CT scan for concussion or other means, ensuring prompt and accurate diagnosis is essential for effective treatment and recovery.
But you shouldn’t have to wait for technology to catch up to find the help you’re looking for.
At The Neural Connection, we’re worldwide leaders in concussion rehabilitation and treatment. And with our 94+ 5-Star Google Reviews, we’ve shown time and time again that people can improve and overcome concussion symptoms when provided the correct dose of therapy, treatment, and trust from a provider.
If you’re still looking for answers to your post-concussion questions, click the link below to schedule a consultation today!
*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.
