How to diagnose tbi?
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A car accident. A football tackle. An unfortunate fall. These things—and more—can cause head injuries. Head injuries can happen to anyone, at any age, and they can damage the brain.
Here’s how damage can happen: A sudden movement of the head and brain can cause the brain to bounce or twist in the skull, injuring brain cells, breaking blood vessels, and creating chemical changes. This damage is called a traumatic brain injury (TBI).
The U.S. Food and Drug Administration continues to study TBI and encourages the development of medical devices to help diagnose and treat it.
TBI is often caused by a bump, blow, jolt, or explosive blast to the head, or a penetrating head injury that disrupts the brain’s normal function. Not all hits to the head result in TBI. But when it happens, TBI can range from mild (like a brief change in mental status or consciousness) to severe (like a longer period of unconsciousness or major problems with thinking and behavior after injury).
About 75 percent of TBIs (or 3 out of every 4) that occur each year are mild. If a person has the symptoms of TBI after a blow to the head, then the brain has been injured. Mild TBIs always involve some degree of brain injury.
Symptoms of mild TBI include:
Moderate and severe TBI can produce more symptoms including:
If you have questions about TBI, talk to your health care provider. Anyone with signs of TBI should receive medical attention as soon as possible. Call 911 in emergency situations.
While some symptoms of mild TBI can be hard to detect, the Centers for Disease Control and Prevention (CDC), the American College of Rehabilitation Medicine, and some others have published guidelines for diagnosing TBI.
A medical exam is the first step to diagnose a potential brain injury. Assessment usually includes a neurological exam. This exam evaluates thinking, motor function (movement), sensory function, coordination, eye movement, and reflexes.
Imaging tests, including CT scans and MRI scans, cannot detect all TBIs. But tests from these FDA-regulated medical devices can help health care providers rule out some of the more serious brain injuries. In particular, these scans can detect bleeding that resulted from the traumatic injury which requires immediate medical or surgical attention.
None of the medical devices cleared or approved by FDA are intended to be used alone without the judgment of a health care provider trained to diagnose and treat TBI. The FDA has not cleared or approved any medical products that are intended to diagnose or treat TBI alone without other diagnostic tests or treatments managed by a health care provider.
The FDA continues to work with the research and clinical community to develop better-designed clinical studies so new medical products can be developed. And the FDA continues to review and evaluate medical devices for safety and effectiveness.
More sensitive and objective ways to diagnose and detect mild TBI are needed. Timely diagnosis is important to prevent repetitive injury and to help develop new therapies. That’s because repetitive injury carries the risk of “second impact syndrome.” If people who have not recovered from a head injury have a second head injury, this can result in more significant injury to the brain and more neurological deficits. And, in some cases, repetitive injury can be fatal or cause dementia later in life.
The FDA’s scientists continue to conduct research on diagnostic tests for mild TBI. The scientists are studying TBI blood tests, special brain imaging, eye movements, and brain wave patterns. They are also investigating using portable imaging devices to detect mild TBI.
Little can be done to reverse initial brain damage caused by trauma according to the National Institute of Neurological Disorders and Stroke. But health care professionals will work to stabilize patients and try to prevent further harm. The severity of long-term effects depends on the seriousness of the injury, location of the injury, the number of previous brain injuries, and the age and general health of a patient.
In early 2021, the FDA authorized marketing of a device to aid in the protection of the brain from effects associated with repeated minor impacts to the head seen on special MRI scans.
The device, called the Q-Collar, is intended for athletes aged 13 years and older. The device should be used with other protective sports equipment, which it does not replace. The Q-Collar does not require a prescription. Use has not been shown to allow for more rapid return to TBI risk activities or to allow for undertaking activities with increased risk of TBI or use of increased force during sports activities.
In the event of a traumatic brain injury, our multidisciplinary team of specialized physicians are equipped with the latest technologies and fellowship training to provide the highest level of treatment.
Diagnosis
Brain injuries are serious and require prompt medical attention and diagnosis. If you or someone you know has experienced a head injury, or are experiencing these symptoms, you should seek immediate care. Diagnosis of traumatic brain injuries typically involve an evaluation by a physician or emergency medical professional and a series of diagnostic imaging tests.
Before taking imaging scans of the brain, physicians often employ the Glasgow Coma Scale, which is a 15-point test that helps determine the potential severity of brain injury by examining motor responses, eye movement and responses, and verbal responses.
During the test, the physician will evaluate the level of consciousness, the ability to obey commands, and responses to stimuli, and then score responses with the lowest number indicating a more severe injury and the highest indicating a less severe injury.
“By assessing the patient’s physical state and coherence, we’re able able to score the injury and take next treatment steps,” says Rebound neurosurgeon, Dr. Ashok Modha.
Imaging Tests
Imaging tests are crucial tools used to examine which areas of the brain have been injured. CT scans cross-sectional images of the brain, providing the physician with detailed information on the extent of injury, particularly of swelling, bleeding and clots. MRI scans use magnetic fields and radio waves to create images of the brain, nerve tissues, and brain stem, and may provide diagnostic information that a CT cannot.
“Diagnostic imaging allows us to pinpoint the areas of the brain affected by the impact, and examine other intricate areas of the brain that may need medical attention,” says Dr. Modha.
When penetration has occurred in a brain injury, physicians may use angiography to take a deeper, inside look of blood vessel damage. Measuring electrical activity with electroencephalography (EEG) in the brain is another method used in assessing brain damage. Because traumatic brain injuries often cause swelling of the brain, a physician may measure pressure with an intracranial pressure monitor.
Treatment
Treatment of traumatic brain injuries is dependent on the severity of injury and cause of injury. While mild traumatic brain injuries typically do not require treatment aside from supervision, rest and certain pain relieving medication, moderate to severe brain injuries typically necessitate immediate emergency care. This could include medication such as diuretics, anti-seizure drugs or coma-inducing drugs, surgery to repair skull fracture or remove bone fragments from the brain, blood clot removal, contusion treatment, or even surgery to drain excess or accumulated cerebral spinal fluid.
Learn more about traumatic brain injury causes and symptoms here.
Other Rebound Brain Injury Resources
What Causes a Concussion and How is it Treated?
Traumatic Brain Injury Causes & Symptoms
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Assessment usually includes a neurological exam. This exam evaluates thinking, motor function (movement), sensory function, coordination, eye movement, and reflexes. Imaging tests, including CT scans and MRI scans, cannot detect all TBIs.
