While baseline, sideline and remote concussion tests can reliably assess brain function pre and post concussion, they are not designed to detect structural damage within the brain.
Instead brain imaging can be used to assess whether there is swelling or bleeding of the brain.
Who Should Undergo Brain Imaging?
- Consider conducting brain scans if the athlete displays any of the following signs:
- Fractured skull
- Penetrating skull trauma
- Loss of consciousness
- Deterioration in conscious state following injury
- Increasing confusion
- Worsening headache post injury
- Persistent vomiting
- Any convulsive movements
- Focal neurological signs
- More than one episode of concussive injury in a match or training session
- High-risk injury mechanism (i.e. high velocity impact, missile injury)
In addition the following groups are at heightened risk of brain injury:
- All children with head injuries
- High-risk patients (i.e. haemophilia, anticoagulant users)
- Athletes who had inadequate post injury supervision
Types of Brain Imaging
There are several brain scans currently available based on different technologies and techniques.
A CT or computerised tomography scan is one of the best techniques to evaluate bleeding or swelling of the brain within the first 24 to 48 hours post concussion.
It is also preferred over an MRI to detect skull fractures, as it faster, more affordable and easier to perform. A disadvantage is that it cannot show microscopic damage to neurons and brain function disturbance.
A magnetic resonance imaging (MRI) Scan is arguably the more appropriate imaging procedure 48 hours or longer after an athlete has suffered a mild head trauma. It is particularly accurate in detecting traumatic lesions of the brain and does not expose athletes to radiation.
Changes in white matter tracts, degraded blood products or small capillary bleeds around nerve cells can also be identified by an MRI.
Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique which provides a calculable measure of the often subtle changes within the white matter tissue of the brain following concussion.
These changes may provide clues as to why concussion manifests in neurological symptoms. Despite showing tremendous potential, DTI may not be applicable to the routine evaluation of concussion.
Find a qualified medical practitioner now for more advice on brain scans.