Diagnosis

Traumatic brain injuries may be emergencies. In the case of more-severe TBIs, consequences can worsen rapidly without treatment. Doctors or first responders need to assess the situation quickly.

Glasgow Coma Scale

This 15-point test helps a doctor or other emergency medical personnel assess the initial severity of a brain injury by checking a person's ability to follow directions and move their eyes and limbs. The coherence of speech also provides important clues.

Abilities are scored from three to 15 in the Glasgow Coma Scale. Higher scores mean less severe injuries.

Information about the injury and symptoms

If you saw someone sustain an injury or arrived immediately after an injury, you may be able to provide medical personnel with information that's useful in assessing the injured person's condition.

Answers to the following questions may be beneficial in judging the severity of injury:

• How did the injury occur?
• Did the person lose consciousness?
• How long was the person unconscious?
• Did you observe any other changes in alertness, speaking, coordination or other signs of injury?
• Where was the head or other parts of the body struck?
• Can you provide any information about the force of the injury? For example, what hit the person's head, how far did he or she fall, or was the person thrown from a vehicle?
• Was the person's body whipped around or severely jarred?

Imaging tests

• Computerized tomography (CT) scan. This test is usually the first performed in an emergency room for a suspected traumatic brain injury. A CT scan uses a series of X-rays to create a detailed view of the brain. A CT scan can quickly visualize fractures and uncover evidence of bleeding in the brain (hemorrhage), blood clots (hematomas), bruised brain tissue (contusions), and brain tissue swelling.
• Magnetic resonance imaging (MRI). An MRI uses powerful radio waves and magnets to create a detailed view of the brain. This test may be used after the person's condition stabilizes, or if symptoms don't improve soon after the injury.

Intracranial pressure monitor

Tissue swelling from a traumatic brain injury can increase pressure inside the skull and cause additional damage to the brain. Doctors may insert a probe through the skull to monitor this pressure.