How a Traumatic Brain Injury is Diagnosed
Once acute care and short-term needs have been addressed following a traumatic head injury, the process of evaluating it to determine its cause, potential brain involvement and ascertaining the severity of the injury begins. Generically, this is referred to as formulating a diagnosis[1]. Of course, the preliminary diagnosis may change, but as the hours, days, months and, sometimes, years pass, the definitive and final diagnosis is made.
If the head injury is, indeed, determined to be a traumatic brain injury, some of the symptoms of it are not outwardly visible whereas others are immediately noticeable. Those that are not may manifest themselves over time, be progressive and correlate with physical and mental activities in which the individual engages. Identifying them may require repetitive monitoring and testing the individual over time by a multidisciplinary team in a post-acute rehabilitation facility such as NeuLife in Mount Dora. The multidisciplinary team will includes a neurologist, who may order and/or interpret CAT scans, MRIs, PET scans and other diagnostic tests; neuropsychologists who perform and assess results of neurobehavioral testing, and other professionals who assess independent functional evaluations. There are still others who analyze behavioral dysfunction and a range of other cognitive deficits. Integral members of the multidisciplinary team at NeuLife in Orlando, Florida, include, but are not limited to physical, occupational, cognitive and speech therapists who help to diagnose and isolate deficits as part of NeuLife’s comprehensive diagnostic evaluation and its development of an individualized Client Goal Plan.
The Client Goal Plan is a “living” plan and will change as the client progresses. It will always be an individualized roadmap for the client to achieve independence to the fullest extent possible. It is NeuLife’s goal to consistently provide the highest standard of care in the delivery of clinically relevant services to achieve successful, sustained outcomes and to exceed the expectations of all persons served.
Among the less outwardly visible signs that help diagnose a traumatic brain injury include the following:
- Inability to tolerate bright light
- Diminished vision
- Dizziness
- Balance problems
- Lethargy
- Memory problems
- Poor judgment
- Diminished organizational skills (sometimes called “Executive Function”)
- Inappropriate emotional responses[2]
In contrast, there are some situations when, although a positive diagnosis of traumatic brain injury cannot be made immediately, it appears very likely that one did occur. Indicia include the following:
- Spinal fluid, which is usually clear, leaking from the nose or ears
- Loss of consciousness
- Dilated pupils
- Respiratory failure
- Paralysis
- Slow breathing and decreased blood pressure
- Loss of bowel or bladder control[3]
There are other methods used for the diagnosis and later monitoring of a traumatic brain injury. One is the Glasgow Coma Scale. It is a 15-point scoring scale that is intended to estimate and categorize an individual’s outcome from brain injury, and thereby can facilitate outcome tracking. Briefly, it scores the following categories:
- Motor response
- Verbal response
- Eye opening
The individual is scored within each category and the scores are then added. An individual with a lower total score generally has a poorer prognosis for recovery while one with a higher total score has a better prognosis.
Another diagnostic gauge is the Ranchos Los Amigos Scale. It measures awareness, cognition, behavior and interaction with the environment. There are eight possible results in this measurement device ranging from “no response” (the lowest) to “purposeful-appropriate” (the highest).
NeuLife’s philosophy is that healing, wellness and personal fulfillment are best achieved in a positive and uplifting therapeutic environment where caring staff encourage, assist and support each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to achieve function and independence.
NeuLife, in Mount Dora, Florida, is a fully accessible post-acute program providing specialized rehabilitation to individuals diagnosed with traumatic brain injury (TBI), spinal cord injury (SCI), traumatic amputations and other catastrophic injuries.
2725 Robie Avenue
Mount Dora, Florida 32757
[1] Merriam-Webster, http://www.merriam-webster.com/dictionary/diagnose
[2] Brain Injury Association of America, http://www.biausa.org/brain-injury-diagnosis.htm#Symptoms
[3] Ibid
