One of the hardest types of injuries to diagnose is a traumatic brain injury (TBI). In fact, a TBI is often referred to as the “invisible injury.” Consider that each brain is unique and no single brain remains the same over time, making it the most complex organ in the human body. Therefore, doctors use several types of tests to diagnose and measure brain injury effects on the body as well as evaluate a person’s speech, cognitive abilities and behaviors. Here are some of the main ways that doctors diagnose traumatic brain injuries.
CAT Scans and Other Imaging Tests
During the initial stages of a brain injury, a diagnosis focuses on physical abnormalities. Diagnosing a brain injury involves using CAT scans and other types of imaging tests.
- CAT scans (computerized tomography) take X-ray scans of various angles of the brain to detect damage, such as bleeding in a person’s brain or bruised brain tissue.
- MRIs (magnetic resonance imaging) involve using radio waves and magnets that render even more detailed images.
- ICP (intracranial pressure) monitoring entails a doctor, neurologist or health care provider inserting a probe in the skull to monitor swelling in the brain caused by a traumatic brain injury.
The Glasgow Coma Scale
Doctors use the Glasgow Coma Scale (GCS) to measure the functioning abilities of a person in three different areas of ability. This is a scoring system that assesses the level of injury, shortly after a brain injury has occurred. It checks a patient’s abilities, including:
- Verbal response or speaking ability—This area of testing is used to determine how well a person can speak or make sense.
- The ability to open the eyes—This entails patients being able to open their eyes when instructed to do so.
- Motor response testing involves an individual’s capability to easily move his or her arms, or not move them, when responding to stimulation that creates some pain.
- After rating a person’s responses in these three categories, a health care provider comes up with a total number. The higher the number, the less severe is the TBI.
Neuropsychological and Cognition Exams
Usually, people who suffer from severe traumatic brain injuries lose some of their mental abilities, meaning that their cognitive or thinking skills are compromised. Doctors use neuropsychological testing to get information about a person’s cognitive abilities, behaviors and motor skills for determining if rehabilitative treatments are needed.
A neuropsychologist gathers information about an individual prior to an injury, such as school records or work performance. This information is then compared to how the person responds after the injury to see if there are significant changes.
Speech and Language Tests
Speech and language abilities are tested, such as how well an individual uses vocabulary and grammar, besides tests for measuring writing and reading skills. Social communication abilities, role-playing and formal tests, are also evaluated.
What’s more, patients are examined for any difficulties in swallowing. If problems are detected, a speech and language pathologist recommends a treatment plan that helps the person be able to swallow correctly. Proper nutrition is also recommended.
Levels of Traumatic Brain Injuries
- A mild TBI is one in which there’s a memory loss that entails less than 24 hours and unconsciousness for less than 30 minutes. The GCS ranges from 13 to 15.
- A moderate TBI involves a GCS of 9 to 12 and memory loss that lasts from 24 hours to up to seven days. Additionally, the person must have remained unconscious for anywhere from 30 minutes to 24 hours.
- A severe TBI is when the GCS was 8 or lower with a memory loss lasting longer than seven days. Furthermore, to be considered a severe TBI, the person must be unconscious for longer than 24 hours.
Considerations and Warnings
- Traumatic brain injury is the leading cause of death and disability among young Americans who are 35 years old or younger.
- It’s also the top cause of premature death and disability, worldwide.
- Sometimes, there is no link between a patient’s long-or short-term abilities or recovery and an initial Glasgow Coma Scale score.
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