In our last video we described the signs and symptoms of a concussion, and we learned that you may not always be able to tell if you’ve had a concussion.

So what do you do next if you think you might be concussed? What are the tests and what are your options?

If you suspect you might have a concussion, what you do right afterward is critical to recovery.

If you’ve hit your head and have any kind of bleeding or loss of consciousness, seek medical attention immediately.

Now, with a serious or moderate head injury, the symptoms are typically obvious and immediate–symptoms like nausea and dizziness and confusion, or loss of consciousness.
The doctor will perform a physical exam to check your nervous system–that is, your brain and spinal cord. The doctor will look for changes in your pupil size, coordination, and reflexes.
 In some cases, the doctor may ask for a CT scan or an MRI to check on the extent of the damage that occurred, to both the skull and to the brain.  One of the biggest concerns here is that an injury can lead to bleeding in or around your brain – this is because when you move the brain, blood vessels can shear.  If that happens, the blood builds up and pushes the brain, which is a medical emergency that requires relieving the pressure immediately.  Often, when someone has a bleed, they have increasing drowsiness and confusion. This is why it’s critical to monitor anyone who’s hit their head.

Now, let’s imagine you don’t have a bleed — which is true for the majority of the cases in which someone gets a mild traumatic brain injury, or concussion.  In this case, nothing is obvious on the brain scan, and from there a concussion is diagnosed by the symptoms.
This is the current standard for diagnosing concussion. But there are 3 main challenges here.  The first is that symptoms don’t always appear immediately after the impact injury occurs, so concussion is sometimes overlooked this way. (2) Next, individual concussions are different: two people may have very different symptoms – one might have little change, and another might have real cognitive impairment.  (3) Even for an individual, a first concussion might show up differently from a second concussion.

Increasingly, neurocognitive testing is used as an objective measure.  When a person is concussed, subtle aspects of cognitive function become impaired, such as memory, attention, impulse control, and visual perception. Using interactive tests on a tablet or computer, health care professionals can detect these small changes in cognitive health…changes that might not otherwise be detectable.

There are other tests in current research and development phase to be able to better quantify concussions – these include using electroencephalography, or EEG, to measure brain waves, as well as blood biomarkers—that is, proteins that are detectable in the bloodstream that indicate brain tissue injury.  Those are still in development but may play an important role in the diagnostic portfolio in the future.

Identifying a concussion early is key to forming a recovery plan and preventing further injury, and this is because these smaller impacts that don’t seem too bad… and are then neglected.  If you have a mild brain injury and you return to work or the playing field too soon, this can increase your chances of more damage and slower recovery. So consult your doctor for the best course of action.

In the next video we’ll tell you about the path to recovery.