Overview
Do You Think You Have Sustained a Concussion?
Because each concussion is different and unique to each individual, identifying how the concussion occurred is important in making a precise diagnosis. Categorizing yourself into 1 of the 2 categories below, as a non-athlete or athlete, is the first step in the evaluation process.
Conventional imaging techniques, such as MRI and CT scans, do not detect concussions. Instead the Concussion Center team uses well-accepted computerized tests combined with a physical evaluation to diagnose a concussion.
Are You an Athlete?
Coaches and Athletic Trainers who suspect an athlete has sustained a concussion, should immediately remove the athlete from play, practice or games. The athlete should not return until evaluated by a medical professional. A medical professional should provide a neurological check, along with a mental status evaluation that includes orientation, concentration, balance and amnesia. No athlete with symptoms at rest or with activity is permitted to return to play.
While many athletes experience only temporary neurological impairment lasting one to two days, some athletes have symptoms lasting weeks to months. That is why it’s important for athletes to undergo a more thorough evaluation by a physician, experienced in evaluating and treating concussions, before starting a progressive return to play.
The following is a summary of the tests that are done to diagnose a concussion in current athletes.
Computerized Neurological Assessment
ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is a widely utilized computerized concussion management program that has been implemented for high school, collegiate, and professional athletes.
ImPACT is a 20-30 minute computer test developed to help sports-medicine clinicians evaluate multiple aspects of neurocognitive functioning following concussion. In addition, ImPACT provides a user-friendly injury documentation system that facilitates the tracking of the injury from the field through the recovery process. Used correctly, the ImPACT test can provide valuable information to athletes, parents and sports medicine practitioners, and promote a safer return to competition.
ImPACT Test Features & Benefits
- Protecting the student athlete
- Measuring athlete symptoms
- Measures verbal and visual memory, processing speed and reaction time
- Provides objective data to help medical experts evaluate and develop a comprehensive management plan
- Assists medical experts to determine safe return to sport
How ImPACT Works
ImPACT testing is recommended for all sports athletes before a collision/contact sports season begins. Cleveland Clinic Sports Health experts administer ImPACT testing to obtain baseline data of an athlete’s symptoms, memory, reaction time, and other cognitive function.
If an athlete sustains a concussion during the season, he or she should be evaluated by a medical expert and undergo another ImPACT test within 24 to 72 hours after a concussion and before the return to competition. By comparing these results to his or her pre-season baseline data, Cleveland Clinic Sports Health experts can determine the severity of concussion.
The athlete then meets with a Cleveland Clinic Sports Health physician for a comprehensive management plan focused on returning the athlete to action safely. Athletes are monitored for recovery and when appropriate (symptom free at rest for 24-48 hours) an athlete can progressively return to play under supervision safely. ImPACT testing may be administered again to determine when an athlete can safely return to play.
Take the ImPACT Baseline Test
Even with ImPACT testing, a thorough medical evaluation is a must after a concussion. This includes neuropsychological assessment, CT and MRI tests to rule out more serious head injury.
- Visit the ImPACT™ Website to learn more about the program.
Cleveland Clinic Concussion App
Changing the trajectory of sports concussion care, the Cleveland Clinic Concussion (C3) mobile application is a tool used for assessing concussion symptoms. Cleveland Clinic athletic trainers used the C3 app to conduct baseline assessments of motor and cognitive function in nearly 11,000 high school and college athletes who play contact sports across Northeast Ohio and in several locations throughout the United States. After baseline data are collected, the C3 app can be utilized to document the individual’s impairments, to assist in managing symptoms, and to help determine when recovery is complete. The C3 app compares assessments of balance, reaction time, memory and vision after a hit to baseline and normative data. The app-based assessment pinpoints the areas of most concern and helps guide therapy over time.
Physical Assessment
After all the tests are compiled, you will meet with your health care provider to review the results and ask any more questions that need to be answered. You then may be assessed by a health care provider and asked to perform a series of physical tests.
Drop Test
A physical test that will asses their reaction time. It takes roughly 5 minutes to complete.
Balance Testing
BESS test (Balance Error Scoring System)
A challenging tool that allows us to check balance in a variety of foot positions, on both a hard and foam surface.
Non-Athlete?
While the concussion may not have occurred on the playing field, there are still diagnostic tools and tests available for those who have sustained a concussion.
C3 Application
An iPad based application that combines the majority of the tests above in to one succinct tool.
The information collected will be transmitted into the medical record system so we can follow all of these parameters along the recovery process. You may be asked to fill some of this out in the waiting room as well. It takes about 20-30 minutes to complete.
Physical Assessment
When undergoing diagnosis, you will meet with your health care provider to review how the concussion occurred and ask any more questions that need to be answered. You then may be assessed by a health care provider and asked to perform a series of physical tests.
Drop Test
A physical test that will asses their reaction time. It takes roughly 5 minutes to complete.
Balance Testing
BESS test (Balance Error Scoring System)
A challenging tool that allows us to check balance in a variety of foot positions, on both a hard and foam surface.
