One does not need to hit one’s head to get a brain injury. It frequently occurs after a car accident, with much long-term sequelae. At least 5 million people are disabled from brain injury. Almost everyone is bound to know someone who has one, and if you are in the right place at the right time, you can help diagnose it in someone else.
A doctor does not need to order any test at all to make the diagnosis of a brain injury, however, she would be remiss not to do so. These tests show the severity, serving as a marker of where the brain is in time. Should things get better or worse, there is now a baseline.
The Patient History and Physical Exam provide most of the diagnosis. See #1 article, below, for common signs to observe. The following tests may be ordered to confirm and assess the present brain anatomy and/or function:
5 Ways to Diagnose Mild to Moderate TBI:
- MRI of the brain – can be normal
- CT Scan of the brain – can be normal
- EEG of the brain – can be normal
- Functional imaging – may become more state-of-the-art – see video.
- Neuropsychiatric Testing – you need this. Don’t think it’s a “Psyche” test because you’re crazy (that’s what people told me they thought). This is a lengthy, comprehensive, extremely scientific test over hours, that will pick up not only mild TBI, but also dementia, Parkinson’s disease, Alzheimer’s disease, and other neurocognitive problems with thinking, like dysxlexia. So Grandpa may have it. Someone, sometime in your life should probably have one to detect even subtle changes in brain function. All you need is a pen and paper, and that’s provided.
Various Tests ordered for a brain injury. Magnetic Resonance Imaging (MRI) and Computed Tomography Scan (CT Scan) may be given with contrast dye such as radioactive gadolinium. Some people may be allergic to gadolium; watch for this if you repeatedly get studied with it. The electroencephalogram (EEG) may detect a place where seizures originate.
Note: A lumbar puncture, or spinal tap is not on this list, on purpose. It is contraindicated for possible brain swelling.
Thoughts: I underwent all these tests, the CereScan and Neuropsyche Evaluation being the most sensitive at picking up my injuries. The MRI and CT Scans showed other injuries in my brain; separately discussed under that diagnoses. I also had the CereScan done to show more changes indicative of traumatic brain injury.
Note: There is a potentially deadly syndrome called diabetes insipidus (DI), caused by traumatic brain injury. Discussed separately, it allows for a diagnosis of traumatic brain injury (TBI) to be made, in retrospect. In other words, you can’t get DI without a TBI. I want you to be on the lookout for it, so that if your friend or loved one starts drinking a lot of water and needs to leave to urinate too frequently, you know that this could be “DI.”
DI is a pathognomonic sign of TBI.
~ Dr. Margaret Aranda
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