TBI Screening / Evaluation

What is TBI Screening/Evaluation?

TBI screening/evaluation refers to the process of assessing a person for a traumatic brain injury (TBI), which occurs due to a blow, jolt, or penetrating injury to the head. The screening helps identify potential traumatic brain injuries, while the evaluation determines the severity, impact, and necessary treatment.

When Should Someone Get a TBI Screening/Evaluation?

Your physician may typically recommend a TBI screening/evaluation in the following cases:

• After a fall, accident, sports injury, or head trauma
• If experiencing persistent headaches, dizziness, memory loss, or mood changes
• For veterans or athletes with repetitive head injuries
• If there is concern about cognitive decline after an injury

What Does TBI Screening/Evaluation Involve?

TBI screening and evaluation involve a structured process to assess brain function, identify injury severity, and determine the need for treatment or rehabilitation. It includes clinical assessments, cognitive testing, imaging, and functional evaluations.

TBI Screening

TBI screening is a preliminary assessment used to identify potential brain injuries and determine if further evaluation is necessary.

Patient History & Symptom Assessment

• Mechanism of Injury: Falls, motor vehicle accidents, sports injuries, or blast exposures.
• Loss of Consciousness: Duration and severity.
• Post-Traumatic Amnesia (PTA): Memory gaps or confusion.
• Common Symptoms:
  • Headache, dizziness, nausea
  • Sensitivity to light/noise
  • Confusion, difficulty concentrating
  • Mood changes (irritability, depression, anxiety)
  • Sleep disturbances

Standardized Screening Tools

• Glasgow Coma Scale (GCS): Measures consciousness level (score 3-15).
• Military Acute Concussion Evaluation (MACE-2): Used in military settings.
• Sport Concussion Assessment Tool (SCAT-6): Used in sports medicine.
• Brain Injury Screening Questionnaire (BISQ): Assesses persistent symptoms.
• Vestibular/Ocular-Motor Screening (VOMS): Identifies balance and vision issues.

TBI Evaluation

TBI evaluation is a comprehensive assessment that includes neurological, cognitive, and imaging tests to determine injury severity and its impact.

Neurological & Physical Examination

• Motor Function & Reflex Testing: Evaluates coordination, strength, and response.
• Balance & Gait Assessment: Identifies instability or vestibular dysfunction.
• Cranial Nerve Examination: Assesses vision, hearing, and facial movements.

Cognitive & Neuropsychological Testing

• Memory & Attention Tests:
  • Montreal Cognitive Assessment (MoCA)
  • Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)
  • Wechsler Memory Scale (WMS)
• Executive Function & Processing Speed:
  • Trail Making Test (TMT)
  • Stroop Test
  • Wisconsin Card Sorting Test (WCST)
• Psychological Screening:
  • Assesses depression, anxiety, PTSD, and emotional dysregulation.

Imaging & Advanced Diagnostics (If Needed)

• CT Scan: Identifies bleeding, fractures, or swelling (used in emergencies).
• MRI (Including Functional MRI - fMRI): Evaluates brain structure and function.
• Diffusion Tensor Imaging (DTI): Detects microscopic brain damage.
• EEG (Electroencephalogram): Assesses abnormal brain activity or seizures.

Functional & Rehabilitation Assessment

• Physical & Occupational Therapy Evaluation: Identifies motor and coordination deficits.
• Speech & Language Testing: Assesses communication and cognitive impairments.
• Vestibular & Oculomotor Testing: Evaluates dizziness, balance, and eye movement issues.

Steps After Screening & Evaluation

• Mild TBI (Concussion): Rest, symptom management, and gradual return to normal activities.
• Moderate to Severe TBI: May require hospitalization, rehabilitation, cognitive therapy, and long-term follow-up.