Over 1.2 million Americans require emergency room treatment for mild head injuries each year. When a person enters the hospital with a suspected brain injury, doctors will often perform a Computed Tomography (CT) scan to rule out bleeding of the brain or other signs of brain injury. Most patients with normal CT scans go home.
However, one-quarter of those patients—320,000 Americans annually—continue to suffer from long-term symptoms such as headaches, defects, and other cognitive deficits, sometimes well beyond a year after the head injury. This has prompted medical researchers at the University of Rochester Medical Center to study this poorly understood phenomenon.
Dr. Jeffrey Bazarian, a brain injury expert, claims that faster and more precise diagnostic testing for concussions would result in better short-term treatment and the greater chance of mitigating long-term neurological complications. He and his colleagues have published their results in the February 2006 issue of Academic Emergency Medicine.
Dr. Bazarian has found that CT scans may show that a person is free of brain injury, but the test can miss damage at the molecular level. When doctors study the nerve cells of concussion patients, the patterns of brain injury are virtually the same for those who’ve suffered mild and severe concussions.
According to Dr. Bazarian, widespread use of the CT scan in evaluating patients for brain injury has created a bias in the way medical professionals think about concussions. “For many people, a more significant axonal injury has occurred,” he explains, “and this underlies the problems they have with motor skill and memory, and may also be a risk factor for later development of Alzheimer’s and Parkinson’s diseases.”
To improve the diagnosis of head injuries and brain injuries, the research team at the University of Rochester has found the following:
- While doctors commonly use the CT scan when diagnosing head injuries, the MRI, PET, and SPECT scans are actually more precise diagnostic tools.
- It is important to test a head injury patient’s memory, coordination, and verbal skills. Evidence shows that athletes with mild concussions continue to perform worse on tests of reaction time, listening abilities, and memory, even when the CT scan was normal.
- In some cases, doctors can diagnose a brain injury by testing for brain-specific proteins in the blood. Experts state that better blood tests are needed on the scene of brain injury accidents to detect these constituents in the blood. Currently available brain biomarkers are not good predictors of patient outcome following a head injury.
The research team points out that in situations like the Iraq war, properly diagnosing and treating head and brain injuries is crucial. “Among coalition forces in Iraq, brain injury has been the signature wound of the war,” Bazarian states, “Undiagnosed brain injury in combat leaders may expose them and their troops to increased risk on the battlefield.” He claims that this gives urgency to developing a more accurate and portable means of brain injury diagnosis.
