Identification

Key Symptoms, Diagnostic Criteria, Progression

There are a myriad of symptoms to be aware of when considering a TBI. The type of injury, severity, and what part of the brain was involved in the injury determine the possible severity. Symptoms may occur immediately after injury or weeks later and may change over time. Not all symptoms need to be present. Any symptoms, or even the absence of symptoms, after any head trauma warrant a visit to a doctor. Sometimes symptoms do not occur immediately after an injury. The severity of the injury and the history of concussion determine the severity of a traumatic brain injury. It is important, no matter the severity, that the patient rests completely from any mental or physical activities, gradually returning to normal activity.

Video: Systemic Barriers to Care: Black Women with the Lived Experience of Brain Injury (1:00:00)

Nneka Mac moderates three groundbreaking panels that explore systemic racism and the urgent need for diversity, equality, and inclusion in the field of brain injuries. In these panels, Black women share their personal experiences to bring awareness to the barriers that exist in the field of brain injury and issue a call to action. The main speakers are Daneen Brooks, Erica Walker, Courtnee Walker, and Davine Mason.

According to the Mayo Clinic, some factors that can affect the TBI diagnosis include having someone present when the incident occurred to answer the following questions:

• How did the injury occur?
• Did the person lose consciousness?
• How long was the person unconscious?
• Did you observe any other changes in alertness, speaking, coordination, or other signs of injury?
• Where was the head or other parts of the body struck?
• Can you provide information about the force of the injury? For example, what hit the person’s head, how far did the person fall, or was the person thrown from a vehicle?
• Was the person’s body whipped around or severely jarred?

If you believe you may have a TBI but the diagnosis did not indicate TBI, you can seek a second opinion. TBI can be misdiagnosed or dismissed, for example, telling the patient they just have a mild concussion or their fall/accident was minor. A brain scan (CT or MRI) is not needed for diagnosis but may be used to check for bleeding on the brain. Any head injury needs to be taken seriously.

Video: How Do You Diagnose a Mild TBI and Prevent Brain Injury from Repetitive Concussions? (1:00)

Diagnostic Criteria

Doctors and clinicians use numerous tests to diagnose a brain injury. There is no single test to diagnose TBI. Several tests are used in conjunction with each other. Some of the tests include brain imaging tests such as a Computerized Axial Tomography (CAT) scan, or a Magnetic Resonance Imaging (MRI) scan. CAT scans are more commonly used for initial diagnosis, with an MRI for follow-up scans. There are also cognitive tests given in which the affected person must answer questions. Those questions are scored and evaluated. Testing for functions including speech, opening one’s eyes, and moving one’s limbs purposefully and easily are also criteria when determining a TBI using the Glasgow Coma Scale (GCS). Other assessments may include swallowing, breathing and lung function, and neuropsychological assessments

A TBI ranking can be assessed from mild to moderate to severe. Table 1 from the The National Institute of Child Health and Human Development (NIH)  shows the differences.

Table 1

National Institute of Child Health and Human Development (NIH)