Understanding TBI Tests
Following a TBI, (including milder injury such as concussion), you may be asked to undergo different tests to assess the severity of the damage suffered to your brain. 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.
A computed tomography scanner uses x-ray and a computer to take pictures of the inside of your body. CT scans are particularly useful for identifying if you have a larger scale injury to your skull or brain, such as a fractured skull or bleeding into the brain, as a CT visualises vessels and blood flow.
An MRI is a Magnetic Resonance Imaging Scan. It gives 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. MRI’s are often used for brain and spine imaging because of the high quality, detailed images that they produce. MRI scans are generally more sensitive than CT scans and may 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.
QEEG is Quantitative Electroencephalography. The EEG records brain waves and brain activity, and the quantitative EEG uses the EEG information and precise measurements to create a brain map.
For this test, you will be required to wear a cap on your head which leads to a piece of equipment that reads brain waves. QEEG can be quite a timely process including the fitting of the cap, in total potentially lasting up to two hours. A QEEG is a safe and pain-free assessment method.1
Neuropsychological testing is a form of evaluation that may take place if you have suffered a TBI. Neuropsychological testing is conducted by a neuropsychologist. This testing can help diagnose the severity of a TBI by assessing the degree of cognitive and emotional impairment. The testing may include a clinical interview followed by testing to assess both cognitive and emotional functioning.
Vestibular therapy testing may take place if you have suffered a TBI and are suffering from dizziness and balance problems. Testing will be carried out by a specialist vestibular physiotherapist to diagnose the degree that you may be suffering from vertigo and other vestibular symptoms. Tests which are undertaken may include the modified Clinical Test for Sensory Interaction in Balance (mCTSIB) – simply put, this is observing a person’s attempt to balance, 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).2
Exercise Intolerance Evaluation
Patients may have to 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 while gradually increasing the intensity and monitoring heart rate and blood pressure. These results 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. 3
- Pinheiro ES, de Queirós FC, Montoya P, et al. Electroencephalographic Patterns in Chronic Pain: A Systematic Review of the Literature. PLoS One. 2016;11(2):e0149085. Published 2016 Feb 25. DOI:10.1371/journal.pone.0149085
- Ingerid Kleffelgaard, Helene Lundgaard Soberg, Kari A. Bruusgaard, Anne L. Tamber, Birgitta Langhammer, Vestibular Rehabilitation After Traumatic Brain Injury: Case Series, Physical Therapy, Volume 96, Issue 6, 1 June 2016, Pages 839–849, https://doi.org/10.2522/ptj.20150095
- Kozlowski KF, Graham J, Leddy JJ, Devinney-Boymel L, Willer BS. Exercise intolerance in individuals with postconcussion syndrome. J Athl Train. 2013;48(5):627-635. DOI:10.4085/1062-6050-48.5.02