December 9, 2023


Concussions, a type of mild traumatic brain injury, are generally diagnosed based on clinical symptoms and neurological assessments. However, in certain cases, imaging tests like computed tomography (CT) scans and magnetic resonance imaging (MRI) may be necessary for a comprehensive diagnosis. This article explores the role of imaging in concussion diagnosis and helps you understand when such tests might be recommended.

Clinical Diagnosis: The First Step

The initial diagnosis of a concussion is usually clinical, involving:

  • A physical examination
  • Neurological tests to assess memory, balance, and coordination
  • Patient history, including the nature and impact of the injury

When is Imaging Recommended?

Severe Symptoms

If you exhibit severe symptoms like intense headaches, repeated vomiting, or seizures, imaging may be advised to rule out more severe injuries like skull fractures or bleeding in the brain.

Worsening Symptoms

If initial symptoms worsen over time, imaging can help identify complications like brain swelling or hematomas.

Unconsciousness or Altered Mental State

Loss of consciousness or a significant change in mental state often prompts further investigation through imaging.

Prior Medical History

Patients with a history of multiple concussions or other neurological conditions may require imaging tests for a more detailed assessment.

Types of Imaging

CT Scan

  • What it Shows: Detailed cross-sectional images of the brain.
  • When it’s Used: Typically the first-line imaging test, especially in emergency settings, to quickly rule out fractures or hemorrhages.


  • What it Shows: Detailed images of brain structures and tissues.
  • When it’s Used: Generally used in non-emergency settings for a more detailed evaluation, especially if symptoms persist over time.

Limitations of Imaging in Concussion Diagnosis

  • A standard CT or MRI often appears normal in concussion patients as these tests are not sensitive to the microscopic changes that occur in a concussed brain.
  • Imaging tests expose patients to radiation (CT scans) or are expensive and time-consuming (MRI).


While imaging tests can provide valuable information, they are generally reserved for specific cases where severe injuries need to be ruled out. If you’ve sustained a concussion, your healthcare provider will evaluate your symptoms, medical history, and current condition to determine if imaging is necessary for your diagnosis.


  1. Giza, C. C., & Hovda, D. A. (2014). The new neurometabolic cascade of concussion. Neurosurgery, 75(Supplement 4), S24-S33.
  2. Davis, G. A., Anderson, V., Babl, F. E., et al. (2017). What is the difference in concussion management in children as compared with adults? A systematic review. British Journal of Sports Medicine, 51(12), 949-957.