How is a concussion diagnosed?
When concussion is suspected, a certified athletic trainer or a physician should evaluate the player on the sideline. A physician or certified athletic trainer should review the symptoms, conduct a neurological exam, test short-term memory recall (questions about the game, opponents and the score), long-term memory recall (questions about name, age, birth date, birthplace) and test the player's ability to stay focused on a task (recite months backwards). If a concussion is suspected or diagnosed, the player should not return to play that day, and should be followed by a medical professional until all symptoms have cleared and should not return to the sport until cleared in writing from a trained medical professional.
Midwest Orthopaedics at Rush sports medicine physicians will typically order a test such as a CT scan or MRI, but these are used to rule out other causes for similar symptoms (such as a brain bleed) and are not required to diagnose a concussion (they will be normal in a concussion).
Unfortunately, it may be difficult to determine if the brain has healed from a concussion. Neurocognitive testing may be helpful in determining if subtle problems with thinking and concentration are still present. This testing can be done through basic memory tests, computer-based programs (like ImPACT) or pen-and-paper testing by a neuropsychologist. ImPACT works by taking a baseline cognition score for each player and then re-evaluating a player after a suspected concussion. This evaluation can be used in conjunction with a physician's examination to determine severity and course of treatment.