A sudden blow to the head, a fall, can cause confusion and unexpected neurological symptoms. While concussion, traumatic brain injury (TBI), and stroke can share certain symptoms, they are distinct conditions requiring very different treatments. This post explores how neurologists differentiate between them and why early, accurate diagnosis is crucial for recovery.
Understanding Concussion
A concussion is a mild form of brain injury, usually caused by a blow or jolt to the head. Neurologists diagnose concussions primarily through a detailed symptom review and neurological exam. Common signs include headache, dizziness, nausea, sensitivity to light, and confusion. Imaging tests like CT or MRI scans may not always show visible damage, so diagnosis relies heavily on clinical evaluation. While concussions are typically not life-threatening, repeated concussions can have long-term consequences, making accurate identification important.
Traumatic Brain Injury (TBI)
TBI encompasses a broader range of brain injuries, from mild to severe, and may involve structural brain damage visible on imaging. Neurologists classify TBI severity using standardized scales such as the Glasgow Coma Scale, or other clinical features to measure the patient’s level of consciousness and responsiveness. Symptoms of moderate to severe TBI may include prolonged loss of consciousness, significant memory loss, speech difficulties, seizures, and motor impairment. CT scans and MRIs help assess bleeding, swelling, or bruising in the brain. Unlike concussions, severe TBIs can require surgery, intensive rehabilitation, and long-term care.
Stroke – A Disruption in Blood Flow
A stroke occurs when blood flow to part of the brain is blocked (ischemic stroke) or when a blood vessel bursts (hemorrhagic stroke). Neurologists identify stroke through rapid clinical assessment and urgent imaging, such as CT or MRI scans, to determine the cause and location. Symptoms include sudden weakness or numbness (especially on one side of the body), difficulty speaking, vision problems, loss of coordination, and severe headache. Stroke requires immediate intervention, minutes can mean the difference between recovery and lasting disability.
Key Diagnostic Differences
Neurologists use a combination of patient history, physical examination, cognitive testing, and imaging to tell these conditions apart.
- Concussion: This is synonymous with mild traumatic brain injury (mTBI). Diagnosed clinically and usually with normal imaging results.
- TBI: Has three degrees of severity and may show physical brain damage on scans.
- Stroke: Characterized by a sudden onset and confirmed through structural or special imaging methods. It may show blood flow disruption.
Understanding the underlying cause is essential for guiding treatment. What works for a concussion may be ineffective or even harmful for a stroke.
When to Seek Immediate Help
Any sudden neurological symptoms or loss of consciousness that follows a head injury should be evaluated right away. Early intervention can prevent complications and improve outcomes.
If you or a loved one is experiencing these symptoms, contact us for expert assessment and treatment. We at St. Michael’s Neurology and Pain Medicine are committed to providing precise diagnosis and advanced care tailored to each patient’s needs.
AUTHOR: Miguel A. Pappolla, MD, PhD, is a board-certified neurologist and board-certified pain medicine specialist in Houston, Texas, with expertise in traumatic brain injury and pain management. A full professor of Neurology at UTMB, he holds board certifications in five medical specialties and has authored over 100 highly cited research papers. With decades of experience as a consultant for the NIH and as a neuroscience educator, Dr. Pappolla continues to advance research and patient care.