Diagnosis of Concussion

A concussion is a type of mild traumatic brain injury that affects how the brain functions. It is diagnosed clinically, not by a single test or scan.

Understanding how concussion is diagnosed can help explain why symptoms may be real and significant—even when imaging is normal.

 

Concussion is a clinical diagnosis

 

Concussion is diagnosed based on:

  • what happened at the time of injury

  • the symptoms that followed

  • how those symptoms change over time

 

There is no single test that can definitively confirm or rule out concussion.

Instead, diagnosis relies on a careful clinical assessment by a medical professional.

 

What typically causes a concussion

 

A concussion can occur after:

  • a blow to the head

  • a fall

  • a sporting collision

  • a motor vehicle accident

  • any force that causes rapid movement of the brain within the skull

 

Loss of consciousness is not required. Many people who sustain a concussion never lose consciousness.

 

Common features used to diagnose concussion

 

A clinician may diagnose concussion if there is evidence of:

  • confusion or disorientation after the injury

  • feeling “dazed” or slowed

  • memory gaps around the event

  • headache, dizziness, nausea, or sensitivity to light/noise

  • changes in concentration, mood, or sleep

 

Symptoms can appear immediately or develop over hours or days.

 

Why brain scans are often normal

 

CT scans and MRIs are usually done to:

  • rule out serious complications (e.g. bleeding, fracture)

  • ensure medical safety

 

In most concussions:

  • there is no structural damage visible on standard imaging

  • the injury affects brain function, not brain structure

 

A normal scan does not mean a concussion did not occur.

 

How concussion affects the brain

 

Concussion temporarily disrupts:

  • how brain cells communicate

  • how energy is used in the brain

  • how efficiently the brain processes information

 

These changes are microscopic and functional, which is why they are not seen on routine imaging.

 

Acute vs post-concussion diagnosis

 

In the early phase (first days to weeks):

  • diagnosis focuses on medical safety and symptom monitoring

  • clinicians watch for red flags or deterioration

 

In the post-acute phase (weeks to months later):

  • the question often shifts from “Was this a concussion?” to

    “Why hasn’t recovery progressed as expected?”

 

At this stage, assessment focuses on function, recovery patterns, and contributing factors.

 

The role of neuropsychology in concussion

 

Neuropsychological assessment does not diagnose the concussion itself.

Instead, it helps to:

  • understand how the brain is functioning after injury

  • identify cognitive inefficiency, fatigue, or load sensitivity

  • distinguish between ongoing brain-based effects and secondary factors (such as anxiety, disrupted sleep, or pacing difficulties)

  • guide recovery, rehabilitation, and return to work or study

 

This is most useful once the early recovery phase has passed.

 

Why diagnosis can feel uncertain

 

Many people are frustrated by:

  • being told “everything looks normal”

  • conflicting advice from different providers

  • uncertainty about whether symptoms are still injury-related

 

This uncertainty is common because concussion affects how the brain works, not always what tests or scans show.

Clear explanation and appropriate timing of assessment are often key to recovery.

 

When to seek further assessment

 

You may benefit from further assessment if:

  • symptoms persist beyond the expected early recovery period

  • thinking, attention, or fatigue are limiting daily life or work

  • you feel stuck, unsure how to progress, or losing confidence

  • return to work or study has stalled

 

At that point, the focus is no longer on confirming the injury—but on supporting recovery and function.

 

Our approach

 

We work alongside medical and rehabilitation providers to:

  • clarify how concussion is affecting cognitive and emotional functioning

  • explain why symptoms may be persisting

  • provide structured guidance for recovery and reintegration

 

If you’re unsure whether your symptoms fit with concussion or whether further support would be helpful, we’re happy to discuss your situation and help you decide on the next step.