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Delay in Diagnosis of Mild Traumatic Brain Injury

Robert Karns

When a traumatic brain injury occurs often times there is a delay in the diagnosis. Mild traumatic brain injury (mTBI) can occur without a loss of consciousness. The Centers for Disease Control and Prevention (CDC) states that a mild traumatic brain injury can occur with a bump, or jolt to the head changing the way the brain normally works. It can occur from a fall that causes the head and brain to move quickly back and forth. According to the CDC, healthcare professionals may describe a mild traumatic brain injury as not life threatening, however even so the effects can be serious. The CDC in its report to Congress indicated that many individuals with mTBI do not receive medical care at the time of the injury and may later present to their primary care physician days, weeks or even months after the injury with complaints of persistent symptoms.

The American Congress of Rehabilitation Medicine (ACRM) defines a mild traumatic brain injury as not requiring a loss of consciousness, occurring if one of the following exists:

  • Any loss of memory for events immediately before or after the accident.
  • Any alteration in mental state at the time of the accident such as feeling dazed, disoriented or confused.
  • Neurological deficits such as headaches or muscle weakness.

An article in the Archives of Physical Medicine and Rehabilitation conducted a study whereby 56% of mTBI cases did not have a documented mTBI related diagnosis in the emergency room of the hospital. The article states that the diagnosis of mTBI was frequently absent from the emergency room medical records despite patients reporting findings consistent with a mTBI diagnosis.

A traumatic brain injury can occur in an accident by striking the head, or it can occur when the head is not struck but simply jolted in a whiplash like injury when the neck snaps back and forth causing the brain to move rapidly inside the skull.

This type of injury is commonly not diagnosed in the emergency room or by treating physicians. MRI scans and CT scans of the head are often normal.

It is important to note that many of the symptoms of mild traumatic brain injury do not occur right away. They may be delayed days or weeks before they appear.

Some symptoms of mild traumatic brain injury are:

  • Poor concentration
  • Sleep disturbances
  • Dizziness
  • Irritability
  • Depression
  • Headaches
  • Nausea
  • Change in smell and taste
  • Sensitivity to light and sounds
  • Confusion
  • Slowness in thinking
  • Difficulty in speaking

A mild traumatic brain injury may not be immediately diagnosed after the injury.

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