Diagnosing Traumatic Brain Injury

Diagnosing traumatic brain injury involves physical and neurological examinations that evaluate the presence and extent of brain injury. During physical examination, vital signs (pulse and blood pressure), irregular breathing patterns, and visible external injuries to the head or body are assessed.

Doctors may need to stabilize a person's vital signs using a ventilator or other breathing machine. Also, doctors identify visible conditions that require immediate medical attention, such as bleeding and skull fracture. X-rays, computed tomography (CT) scans and magnetic resonance imaging (MRI) are used to see where in the head the injury has occurred.

Following the physical examination, doctors perform a neurological evaluation to assess the extent of brain damage. Doctors may ask the victim for the current calendar date, the President's name, or other questions that may help assess the victim's level of consciousness. A person's level of consciousness determines the severity of brain injury.

Two scales widely-used to evaluate a person's level of consciousness are the Glasgow Coma Scale and the Rancho Los Amigos Scale. The Glasgow Coma Scale is a simple, 15-point scale that evaluates the level of consciousness and chances for recovery. The Rancho Los Amigos Scale is a much more complex tool that categorizes a patient into eight separate levels of consciousness.

Determining the Type of Traumatic Brain Injury

Physical and neurological evaluations allow doctors to not only identify the presence of brain injury, but to evaluate the type of brain injury. A person may have mild (concussion), moderate, or severe open or closed head injury.

Mild traumatic brain injury, or concussion, can go undiagnosed for days or weeks, as mild traumatic brain injury symptoms are subtle and may emerge some time after the initial injury. A person may be depressed or have memory lapses, headaches, or insomnia.

Moderate to severe brain injury victims may be unconscious or show severe physical and cognitive impairment such as paralysis, problems with breathing, or a low level of consciousness such as coma.

Open head injury is apparent during physical examination; a fractured skull may expose brain tissue, and bleeding may be severe. Closed head injury requires extensive physical examination, as brain injury is not readily apparent. During physical examination, doctors evaluate increased intracranial pressure and brain swelling using an intracranial pressure monitor and other brain scans such as MRI and CT scans.

After a traumatic brain injury victim is diagnosed, doctors immediately treat the injury to minimize complications and long-term consequences. To learn more about traumatic brain injury treatment and traumatic brain injury lawsuits, please read other articles on this site.

[Last revision: March 2007]