Diagnosing Concussion

Concussion is caused by an injury to the brain and may or may not be accompanied by a loss of consciousness. Symptoms, which may appear immediately or evolve over minutes or hours, commonly resolve within days. Any time a concussion is suspected, you should see a doctor immediately.

Most people with a concussion tend to recover within a few days. It’s recommended that you see a concussion specialist if symptoms continue for more than three days. Sometimes, people in demanding environments such as school or work experience increased symptoms after a concussion. In these cases, NYU Langone doctors recommend returning to those activities gradually.

At the Concussion Center, our experts diagnose concussion in children, who receive treatment through Hassenfeld Children’s Hospital at NYU Langone,and adults, determining the best course of treatment for each person.

Symptoms

Most concussions do not result in loss of consciousness, and many people with a concussion recover within a few days to several weeks. Signs and symptoms of a concussion may include the following:

• headache
• dizziness
• fatigue
• lack of energy
• anxiety
• change in judgment
• loss of balance
• coordination problems
• sensitivity to light and noise
• difficulty concentrating or
• retaining new information
• memory disturbances or memory lapses
• sleep disturbances

Some people have no symptoms for hours or even days after a concussion. However, it is important that anyone with a head injury be evaluated immediately to reduce the risk of serious complications.

A person with a more severe head injury may have these same signs and symptoms, in addition to the following:

• a headache that worsens or does not go away
• repeated vomiting or nausea
• convulsions or seizures
• an inability to awaken from sleep
• slurred speech
• weakness or numbness in the extremities
• loss of coordination and falls
• increased confusion, restlessness, or agitation

In rare circumstances, some people have no symptoms for hours or even days after a concussion. However, it is important that anyone with a head injury be evaluated immediately to reduce the risk of serious complications, such as seizures, changes in cognitive ability, or bleeding or swelling in the brain.

Doctors at the Concussion Center evaluate and, if necessary, manage any symptoms caused by injuries to the head and brain.

Diagnostic Tests

There is no single test used to diagnose a concussion. If your NYU Langone doctor suspects a concussion, he or she may perform a physical exam to check your strength, balance, coordination, and reflexes.

Your doctor also asks questions about your medical history, including details about the injury—its cause and when it occurred, for example—and any symptoms you have noticed. Your doctor may also ask questions that test your ability to pay attention, learn, remember, and solve problems.

The following tools may also be used in making a diagnosis.

CT Scans

A CT scan is a type of X-ray that creates detailed images of your tissue and internal organs. These images can show whether your brain is bruised, swollen, or bleeding.

MRI Scans

A doctor may order an MRI scan to better view the brain and determine whether there is any swelling or bleeding. MRI uses a magnetic field and radio waves to create two- or three-dimensional pictures that may reveal smaller areas of bleeding and bruising in the brain.

Neuropsychological Testing

Evidence of a concussion may not always be visible on MRI or CT scans, so a doctor may perform neuropsychological tests to determine if you are having difficulty with cognition and memory after a concussion. These tests may also detect any emotional changes.

A neuropsychological test may involve answering questions or performing tasks. For example, to test for attention span and memory, the doctor might ask you to repeat a series of numbers, letters, or words. To test for language and speech skills, you might be asked to name the objects in pictures or as many words as you can think of that begin with a certain letter.

Neurodiagnostic Testing

To help diagnose a brain injury and pinpoint its location in the brain, NYU Langone doctors might perform a neurodiagnostic test called EyeBoxCNS to track eye movements. A person with a suspected brain injury watches a small picture move on a computer screen for a few minutes while a device tracks the person’s eye movements.

Pioneered at NYU Langone, the technology detects weakness in the nerves that move the eye. This correlates to the location and nature of the brain injury, helping our doctors to better develop a treatment plan.