Diagnosis of Traumatic Brain Injury (TBI)

Chapter 6 – Diagnosis of Traumatic Brain Injury (TBI)

How is TBI Diagnosed?

Diagnosing traumatic brain injury (TBI) is a careful process. Doctors combine physical exams, questions about how the injury happened, and medical tests to figure out how serious the injury is and how it’s affecting the brain.

Initial Assessment

When someone arrives at the hospital after a head injury, doctors:

  • Check vital signs (breathing, heart rate, blood pressure)
  • Evaluate the person’s level of consciousness
  • Ask about symptoms like headache, confusion, or memory loss
  • Look for visible injuries to the head or face
  • Test muscle strength, reflexes, and pupil reactions

A major tool doctors use is the Glasgow Coma Scale (GCS). It scores eye opening, verbal response, and movement. The total score helps classify the injury as mild, moderate, or severe.

Imaging Tests

Doctors often order brain scans to check for bleeding, swelling, or fractures:

  • CT Scan (Computed Tomography)
    • Fast and widely used in emergencies
    • Shows bleeding, fractures, swelling, and large injuries
  • MRI (Magnetic Resonance Imaging)
    • Gives a more detailed view of brain tissue
    • Better at detecting smaller injuries or damage not visible on CT scans
    • Usually done later if symptoms persist

Neurological Exams

Doctors and specialists (like neurologists or neuropsychologists) may run detailed tests to check:

  • Memory and thinking skills
  • Balance and coordination
  • Vision and hearing
  • Speech and language abilities
  • Emotional and mental health

These exams help identify hidden problems that scans might miss.

Neuropsychological Testing

Some patients need neuropsychological testing, which involves:

  • Problem-solving tasks
  • Memory exercises
  • Language skills tests
  • Attention and concentration checks
  • Emotional evaluations

These tests help doctors understand how the injury affects daily life and plan therapy.

Importance of Accurate Diagnosis

A correct diagnosis is crucial because:

  • It guides treatment and rehabilitation
  • It helps predict recovery outcomes
  • It ensures patients get proper medical care and therapy
  • It helps families understand what to expect

If symptoms persist or worsen, it’s important to follow up with a doctor—even months after the injury.

Why Some Injuries Don’t Show Up Right Away

Some TBIs, especially mild ones, don’t appear on CT scans or MRIs. That’s why doctors rely on symptoms and clinical exams, not just imaging.

Always tell your doctor about any new or ongoing symptoms after a head injury. Even small changes can be important clues.

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