Understanding TBI tests

Understanding TBI Tests

Following a TBI, (including milder forms such as concussion), you may be asked by your healthcare team to undergo imaging procedures and/or other assessments to determine the impact and/or severity of your brain injury. The results of these tests and procedures will help inform and guide the way that your injury is treated and/or managed. What tests you will be asked to undertake will depend on your individual situation and the types of symptoms you may be experiencing.

Some of these tests may be a little scary if you haven’t encountered them before. To help ease any fears you may have, we’ve provided some further information on what these tests may include.

Imaging Procedures

Computed Tomography (CT) Scan – A CT scan uses x-ray and a computer to take pictures of the inside of your body.  CT scans are quick to perform and  are particularly useful for identifying other injuries to your skull or brain, such as skull fracture or intracranial bleeding.

Magnetic Resonance Imaging (MRI) Scan – MRI scans give extremely detailed images of the inside of the body. Instead of using x-rays, an MRI uses strong magnets, low energy radio waves and a computer to create images. MRIs are often used for brain and spine imaging because of the high quality, detailed images that they produce. MRI scans generally take longer to perform than CT scans but due to their higher level of detail they may be able to detect abnormalities not found on a CT scan.

In Australia, MRI scans are not generally used in routine practice for mild TBI or concussion. Advanced research projects are using a range of newly developed MRI techniques to determine whether these MRI scans could be useful in the clinical management of mild TBI in the future.

Other Assessments

Neuropsychological Testing- Following TBI, an individual may be referred to a neuropsychologist to undergo neuropsychological testing. This type of testing can help diagnose the severity of a TBI by assessing the degree of cognitive and emotional impairment, and generally comprises of a clinical interview followed by a number of pen-and-paper and/or computerised tests to evaluate cognitive skills and emotional functioning, including attention span, concentration, orientation, memory, language (receptive and expressive), motor abilities and sensory awareness, new learning, mathematical reasoning, spatial perception, abstract and organisational (executive) thinking, problem solving, social judgement, mood, as well as general psychological adjustment. A treatment plan is then put together by the neuropsychologist based on the person’s results.

Quantitative Electroencephalography (QEEG)- QEEG is a testing technique that requires a person to wear a specialised cap on their head, which detects the electrical activity of the brain (brain waves) from the surface of the scalp. Specialised computer software is used to process this information and to create maps of brain wave activity that can help a clinician understand the impact of your brain injury and help guide and assess the efficacy of treatments they may prescribe.

While QEEG is a safe and pain-free assessment method, it can be quite a timely process potentially lasting up to two hours. This is largely due to the time required to fit the cap properly.

Vestibular Therapy Testing – Vestibular therapy testing may take place if you have experienced a TBI and are suffering from dizziness and balance problems. Testing will be carried out by a specialist vestibular physiotherapist, who will assess the severity of vertigo and other vestibular symptoms you may be experiencing. Tests which are undertaken may include the modified Clinical Test for Sensory Interaction in Balance (mCTSIB).  Simply put, vestibular therapy testing involves observing a person’s attempt to balance, perform a single-leg stance, tests of the oculomotor system (eye movements), head-thrust test, clinical Dynamic Visual Acuity Test (DVAT) – assessment of gaze stability in head movement, and positional testing (Dix-Hallpike test and Roll test).

Exercise (In)tolerance Evaluation- Patients may take part in an evaluation to monitor their tolerance or intolerance to exercise. These tests will potentially involve using a treadmill or other forms of exercise equipment (e.g. stationary exercise bike). This form of testing involves gradually increase the intensity level of the exercise being performed, while monitoring changes in heart rate and blood pressure. Results of the testing session will be compared to the resting profile of a patient to use in the evaluation. Patients will also need to advise the person administering the test if any of their symptoms return or worsen during the testing process.

Learn more about the basics of the brain to further understand what happens during a traumatic brain injury here.

Updated July 2023