What Tests are Done for Traumatic Brain Injury? (TBI Test)

Specialized Testing For Traumatic Brain Injury

Traumatic brain injury (TBI) is common and accounts for more than 3 million emergency department visits per year in the United States. The majority of these visits are for mild injuries, mostly the result of falls and motor vehicle crashes.

The challenge for doctors is to identify which of these patients has an acute or severe traumatic brain injury, something that is not always immediately evident and which often leaves patients, who are observed and sent home, undiagnosed.

How are Head Injuries Diagnosed Anyway?

According to Columbia University’s Dept. of Neurology:

“The diagnosis of a head injury is made with a physical examination and diagnostic tests. During the examination, the doctor obtains a complete medical history of the patient and family and asks how the injury occurred. Trauma to the head can cause neurological problems and may require further medical follow up….”

The article on head injury at Columbia University continues…

“Diagnostic tests may include:

• Blood tests
• X-ray. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film.
• Computed tomography scan (also called a CT or CAT scan). A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
• Electroencephalogram (EEG). A procedure that records the brain’s continuous, electrical activity by means of electrodes attached to the scalp.
• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.”

One of these blood tests that helps predict the seriousness of a head injury and detect the status of the brain damage is the S100B test.  According to a Rochester Medical Center study, widespread use of the blood test could result in a 30 percent reduction of  in costly CT scans.

CT scans are still the most favored method currently being used in emergency rooms for the screening of head injuries.  This is because CAT scans do help determine the amount of bleeding in the brain.  However this type of scan does not detect more subtle injuries to the brain’s neurons, which can result in lasting neurological defects.

Testing for TBI (Traumatic Brain Injury) after a Serious Head Injury?

In fact, 95 percent of CT scans look normal for patients with a relatively mild but potentially life altering injury, said Dr. Jeffrey Bazarian, M.D., M.P.H., associate professor of Emergency Medicine, Neurology, and Neurosurgery at URMC.

Dr. Bazarian suggests that recent news stories about tragic head injuries—from the sudden death of actress Natasha Richardson (wife of actor Liam Neeson) after hitting her head in a skiing accident, to  brain-injured military members and concussed young athletes—underscore the need for a simpler, faster, accurate screening tool for those suffering from traumatic brain injuries.

The S-100B blood test was recently determined to relay critical information about how the blood/brain barrier (BBB) is functioning after a head injury so it can be a useful tool for patients with mild injuries.

Previous studies have shown the S-100B protein biomarker found in the blood increases rapidly after an injury. If measured within four hours of the injury, the S-100B test accurately predicts which head injury patients will have a traumatic abnormality such as hemorrhage or skull fracture as good as a head CT scan.

The S-100B test only takes about 20 minutes to get results and could spare many patients unnecessary radiation exposure.

In a 2019 interview with Science Daily, Bazarian said, “the S-100B blood test is an important part of the tool set we need to improve our treatment of patients with brain injuries. It’s not the ultimate diagnostic test, but it may make things easier for patients, and it will help doctors sort through difficult clinical decisions.”

Before the S-100B blood test, if doctors suspected a life-threatening head injury, they would at times be forced to perform an invasive procedure called a ventriculostomy.

During a ventriculostomy, doctors insert a small tube through the wall of the skull and drain some of the fluid, and compare the concentration of albumin protein in the spinal fluid to the concentration in the patient’s blood. Increased protein levels may be a sign of severe brain or spinal cord injury.

However, due to the S-100B test, doctors can more accurately predict the function of brain 12 hours after an injury, eliminating the need for more invasive procedures.

“Dealing with a traumatic brain injury is not something you should have to do by yourself”

There are elements to this process that are crucial to the success of your treatment. The first thing to do is to make sure that you are receiving the best specialized test and are being seen by specialized doctors.

An attorney who specializes in traumatic brain injuries can also be helpful and often times a necessary part of your recovery. If you have suffered a traumatic brain injury, take the first steps to ensure that you receive the care you need, and contact a personal injury lawyer who can guide you to the specialists and treatment you need and who can make sure that the right person pays for that treatment.

At Fisher Stark, we have experience with traumatic brain injuries and are eager to see our clients properly diagnosed and set on the path to recovery. If you have been diagnosed with or suspect that you or a loved one has experienced a serious head injury we invite you to call us at at (828) 505-4300 to see how we can be of help.