Concussion testing is not a single procedure but a comprehensive series of assessments used to evaluate brain function following a suspected traumatic injury. This evaluation aims to detect the subtle, temporary changes in cognitive and physical abilities that characterize a concussion, also known as a mild traumatic brain injury (mTBI). Because the effects of a concussion can be vague and may not show up on standard brain imaging, testing is necessary to quantify and monitor these changes.
The Goals of Concussion Assessment
The primary objective of a concussion assessment is to determine if a brain injury has occurred and to establish the severity of the resulting symptoms. Healthcare professionals use these tools to identify functional deficits in areas like memory, attention, and balance that may not be immediately obvious. Assessments also establish a personalized benchmark for recovery by evaluating the individual’s post-injury status.
These assessments distinguish between the acute effects of the injury and the individual’s normal state of functioning. This information guides the initial management plan, often involving a period of physical and cognitive rest. The collected data monitors the resolution of symptoms and ensures brain function has returned to an uninjured level before the individual resumes full activity.
Immediate Clinical Evaluation Methods
The acute evaluation performed by a medical provider immediately after a potential injury involves a comprehensive approach to check for signs of brain dysfunction. This begins with a detailed symptom assessment using a graded checklist to document the presence and severity of issues like headache, nausea, dizziness, and sensitivity to light or noise. The provider then conducts a neurological screen to check basic functions, including reflexes, muscle strength, and coordination.
A specialized component of the exam is the oculomotor assessment, which looks for problems with eye tracking and convergence, as these functions are frequently affected by concussions. Balance and gait are also tested through specific tasks, such as the modified Romberg test or tandem gait, to objectively measure postural stability. Brain imaging like a CT or MRI scan may be ordered if “red flag” symptoms—such as prolonged loss of consciousness, worsening headache, or repeated vomiting—suggest a more severe structural injury like a hemorrhage.
Standardized Neurocognitive and Balance Testing
Formalized testing tools provide objective, quantifiable data on the status of the individual’s brain function. A common practice, especially in athletics, is baseline testing, where a person takes these assessments when healthy to establish their personal, pre-injury performance score. If an injury occurs, a post-injury test is administered and the results are compared against the established baseline to detect a decline in function.
Standardized sideline tools, such as the Sport Concussion Assessment Tool (SCAT), incorporate symptom checklists, immediate memory recall, and concentration tasks. Computerized Neurocognitive Tests (CNT), like ImPACT or the DANA Neurocognitive Test, measure specific cognitive domains. These tools evaluate processing speed, reaction time, visual and verbal memory, and are sensitive enough to detect subtle impairments. Balance is also formally assessed using systems like the Balance Error Scoring System (BESS) or force plate technology, which quantify postural sway and stability.
Interpreting Results and Guiding Recovery
The final diagnosis and recovery plan are determined by a medical professional who synthesizes the reported symptoms, physical exam findings, and standardized test scores. There is no single “pass/fail” score that automatically confirms or rules out a concussion, as the diagnosis relies on comprehensive clinical judgment. Symptom reports are important, but objective data from neurocognitive and balance tests help confirm the physiological recovery of the brain.
Testing guides the Return-to-Play or Return-to-Learn protocols, which ensure a gradual, symptom-free return to activity. The individual is not cleared to resume full, unrestricted activity until their symptoms have fully resolved and their post-injury test scores have returned to their personal baseline or within a normal range. This individualized approach ensures the recovery process is tailored to the specific nature and severity of the injury.