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The extent of damage in a severe head injury can be assessed with computed tomography scan (CT scan), magnetic resonance imaging (MRI), positron emission tomography (PET) scans, electroencephalograms (EEG), and routine neurological and neuropsychological evaluations.
Doctors use the Glasgow Coma Scale to evaluate the extent of brain damage based on observing a patient's ability to open his or her eyes, respond verbally, and
respond to stimulation by moving (motor response). Patients can score from three to 15 points on this scale. People who score below eight when they are admitted usually have suffered a severe brain injury and will need rehabilitative therapy as they recover. In general, higher scores on the Glasgow Coma Scale indicate less severe brain injury and a better prognosis for recovery.
Patients with a mild head injury who experience symptoms are advised to seek out the care of a specialist; unless a family physician is thoroughly familiar with medical literature in this newly emerging area, experts warn that there is a good chance that patient complaints after a mild head injury will be downplayed or dismissed. In the case of mild head injury or postconcussion syndrome, CT and MRI scans, electroencephalograms (EEG), and routine neurological evaluations all may be normal because the damage is so subtle. In many cases, these tests can't detect the microscopic damage that occurs when fibers are stretched in a mild, diffuse injury. In this type of injury, the axons lose some of their covering and become less efficient. This mild injury to the white matter reduces the quality of communication between different parts or the brain. A PET scan, which evaluates cerebral blood flow and brain metabolism, may be of help in diagnosing mild head injury, although this is still largely considered to be an experimental procedure.
Patients with continuing symptoms after a mild head injury should call a local chapter of a head-injury foundation that can refer patients to the best nearby expert.
— Carol A. Turkington
