Traumatic Brain Injury - Diagnosis

Patients suffering TBI are typically brought to a hospital emergency room for initial diagnosis and treatment. Once vital signs are assessed and stabilized, and other life-threatening injuries are identified and treated, the process of diagnosing the extent of brain injury begins.

A complete neurological evaluation is performed to rule out conditions requiring neurosurgical attention, such as hematomas, depressed skull fractures, and elevated intracrantial pressure (ICP). X-rays, CT scans, and/or MRI scans may be performed to determine if the bones of the skull are fractured and if bone fragments have penetrated the brain tissues.

The patient may be presented with a series of questions (What is your name? Where are you? What day is it?) and given simple commands (Wiggle your toes. Hold up two fingers.) to determine if he or she can open their eyes, move, speak, and understand what is happening around them. If possible, a detailed medical history is performed to identify any previous injuries, existing seizure disorders, learning disabilities, prior psychiatric or psychological treatment, and/or substance abuse.

The patient's degree of consciousness is assessed to determine the severity of brain injury and predict his or her chances for recovery. To do this, physicians typically use the Glasgow Coma Scale (GCS), which measures the patient's ability to open their eyes, move, and speak. The more severe the injury, the lower the total score suggesting little chance for complete recovery.