After a traumatic event, life-threatening injuries will be taken care of, and the medical team will look for signs of TBI. A key part of that diagnosis and treatment involves determining how badly the brain is injured.
When a patient loses consciousness, the amount of time that they’re unconscious is important in determining the extent of the brain injury. Usually, the longer the loss of consciousness, the more severe the injury.
When the patient is conscious, a series of questions may be asked to determine their mental state. Questions such as “what is your name?”, “what is today’s date?”, and “do you know where you are?” can be asked to help determine if the patient is confused. The patient may also be asked to perform simple movements such as holding up a specific number of fingers or moving their limbs in order to determine if they can move and understand what is happening around them.
When possible, a detailed medical history is taken. Getting information about other injuries or accidents is important, and sometimes patients don’t mention these. Reasons for this can include:
- Some patients may not consider the injury serious because they were told the condition was mild or just a "bump on the head"
- Some patients may not realize that they received a brain injury because they were briefly unconscious when it happened
- Some patients may be focused on a more severe injury that occurred at the same time
- Some may be too embarrassed to mention certain symptoms, such as memory problems or feeling dazed
Another key step in the diagnosis of TBI is a thorough examination of nervous system function, called a neurological exam. Imaging tests of the head such as MRIs, and CT scans can show broken bones, bleeding, swelling, and other injuries.
Unfortunately, these imaging tests are not always available, especially in combat situations. Also, the signs of traumatic brain injury may not appear on these scans. Some more advanced tests, such as PET scans and DTI scans, can give the medical team more information on the injury.
It’s important to know that patients with metal objects in their body may not be able to have some tests such as MRI’s.