What Are Concussion Tests?

A concussion test is a type of noninvasive medical examination used to determine whether someone has had a concussion. A concussion is a temporary change in brain function that occurs due to a traumatic brain injury (TBI). It can cause problems with thinking and mood, and it can take weeks to years to heal from a concussion.

This article will discuss when a concussion test is needed, the types of tests for concussion, and how results are interpreted.

Why Are Concussion Tests Needed? 

A mild or moderate TBI can cause damage to the brain that isn't detectable with brain imaging tests. Yet the damage can cause serious symptoms, including headaches, emotional changes, difficulty concentrating, and memory problems.

Additionally, the effects of a concussion can be vague and hard to describe. Concussion testing can help identify and quantify these changes. 

If you don't have time to heal or if you experience further brain injuries while recovering from a concussion, the effects can be prolonged and worsen. That is one reason why concussion testing is crucial—if you or your child has had a concussion, it's important to get a diagnosis and follow medical recommendations to avoid further harm to the brain. 

Getting a concussion diagnosis can help with setting expectations. Work colleagues, teachers, family, and even the person who experienced a concussion might not understand why a person is not feeling the way they normally feel or cannot do what they normally do.

Often, concussion testing can assess how the effects of a concussion are improving over time. As you improve, you will be able to participate in rehabilitation and follow your doctor's instructions for gradually getting back to work, school, and other activities. 

What Do They Measure?

Concussion tests can measure subtle aspects of brain function, such as visual or auditory (hearing) perception and response speed. These abilities can be impaired due to the damage of a concussion. 

A TBI can also cause serious injuries, like a skull fracture, swelling, bruise, or a bleed in the brain. These types of injuries can be detected with imaging tests, and they may require surgical or other interventions.

Generally, brain damage from bleeding or swelling would cause focal neurological symptoms and signs, such as partial vision loss, numbness, and weakness.

Concussion testing measures more subtle problems, like slow decision-making. You can have a concussion along with detectable brain injuries or in the absence of detectable brain injuries.

Types of Concussion Tests

There are several different types of concussion tests. You may have one or more of these, depending on the standard test that is used in your school, sports league, or by your doctor. 

Concussion tests include:

• Online checklists: A number of different online checklists are available for concussion screening. These tests may include questions about your symptoms and they are often used as self-tests, but they are not intended to replace an evaluation by a qualified medical professional.
• Baseline and post-injury tests: Many schools and sports leagues administer preseason skill measurements that can include memory tests or tests of speed and accuracy, either in an interview format or with computer testing. You might be asked to retake the test for comparison if you have experienced a TBI. 
• Standardized Assessment of Concussion (SAC): This five-minute test can be done on the field sidelines after a sports injury or later. It is an evaluation of orientation, immediate memory, neurologic function, concentration, and delayed recall.
• King-Devick concussion test: This two-minute test can be done on the sidelines after a sports injury or at a later time, and it is an assessment of language, eye movement, and attention.  
• Post-concussion symptom scale: This concussion test includes 18 questions that involve neurocognitive factors (examples include difficulty concentrating or difficulty remembering), physical symptoms (examples include headaches and dizziness), and emotional symptoms (examples include sadness or irritability).
• Sport Concussion Assessment Tool (SCAT): This test includes an on-field assessment noting red flags or signs of a concussion, memory assessment using Maddocks questions (a short list of specified questions), Glasgow Coma Scale (GCS), and cervical spine assessment. An off-field assessment of symptoms involves cognitive, neurological, balance, and delayed recall evaluation.
• Buffalo Concussion Physical Examination (BCPE): This test is a modified physical examination that assesses neck tenderness and range of motion, head, jaw, and face abnormalities, eye movements, eye examination, and coordination.

After a concussion, you will likely also have a physical examination, including a full neurological examination. This is most often done in a doctor’s office. A concussion should not cause changes in a physical examination.

Interpreting Results 

Concussion tests measure subtle changes in brain function, but they do not rule in or rule out a concussion. Your doctor would make a diagnosis based on your symptoms, physical examination, and your concussion test results.

For example, if you broke several bones and are taking powerful pain medications, your concussion test results can be abnormal even if you did not experience a concussion. 

The results of your concussion testing can be compared with your results prior to the head injury. Often, baseline testing is required for participation in certain sports leagues, both at the professional and amateur levels. A worsened score can be a sign that your head injury has impaired your brain function.

Sometimes testing can be done within a few hours of the head trauma and then again a few days later. 

If you did not have measurements taken prior to your head injury, your responses can be compared with the average results of people your age, although that type of comparison is not as reliable as a comparison with your own pre-injury results.

Summary

Concussion tests are done after a suspected head injury and may be done after diagnosis to assess how healing is progressing. They are noninvasive tests that measure brain functions that can be affected by a concussion. There are several different concussion tests that vary in how they are given and what they measure.

A Word From Verywell

If you have had a head injury and think you might have had a concussion, you should get medical attention. Most of the time, people recover from a concussion, but it takes time. Testing can help establish the extent of your injury and help assess your improvement as you are recovering.

While you are recovering, you need to take care of yourself by getting enough rest, avoiding stress, avoiding another head injury, and possibly getting medical care for the physical and emotional effects of your concussion.