Posted August 21, 2024 • 6 min read
Conventional wisdom on brain trauma has been upended in recent years by research showing that there is no such thing as a “minor” concussion—and just a single concussion can cause long-lasting health issues.
Science is also uncovering new ways to identify concussions, including using artificial intelligence (AI) and blood tests for faster and more accurate detection.
These breakthroughs could help people who suffer concussions, which often go undiagnosed, get proper treatment—and full compensation—for concussion injuries resulting from car, truck, slip and fall, and other accidents.
Concussion Science Steadily Improving
A traumatic brain injury (TBI) is an injury that affects the brain’s functioning. The most common type of TBI is a mild traumatic brain injury, or mTBI, better known as a concussion.
Around 2.5 – 5 million TBIs are reported each year in the United States. Concussions account for 80 – 90% of these head injuries. But as many as 50 – 90% of concussions may go without a formal diagnosis, putting patients at risk of serious complications such as brain bleeds and cognitive impairment.
Describing a brain injury as “mild” can be misleading. While a concussion might not be life-threatening, if untreated, it can cause lifelong severe health problems, researchers are learning.
- A 2013 study published in the journal Radiology found that a single concussion can cause structural changes to the brain for at least one year after injury, including areas of the brain that affect attention, anxiety, and memory.
- Researchers at UCSF discovered a connection between concussions and an increased risk for neurological decline. Their research shows that a single concussion is associated with an increased risk of Parkinson’s disease and dementia.
- UPenn researchers found that a single head injury is associated with a 1.25 times increased risk of dementia.
- A mild concussion could increase a patient’s stroke risk for up to five years after their injury, according to researchers at the University of Birmingham in England.
- There is evidence that a concussion can exacerbate or cause new mental health issues like anxiety and depression.
- Most people recover from a concussion within 7 to 10 days, but some suffer prolonged effects—a condition called post-concussion syndrome. Post-concussions syndrome can last for years and even be permanent, according to a recent study published in the Journal of Neurotrauma.
Scientists still aren’t sure how concussions damage the brain, although new research suggests that they may affect the brain’s blood vessels and lymphatic vessels.
Advances in artificial intelligence are allowing scientists to see tiny, structural changes in the brain that were not previously detectable. Using an AI technique called “machine learning,” researchers at New York University were able to accurately identify changes in the brains of contact sport athletes who had not received a concussion diagnosis.
The NYU researchers say that, in addition to spotting “invisible” brain damage that was previously undetectable by traditional medical images such as CT scans, AI imaging techniques may help experts to better understand the biological mechanisms underlying brain injury.
New AI Detects Concussions With 99% Accuracy
Researchers are busting many myths associated with brain injury and concussions. One of these myths is that you lose consciousness after a concussion. Most concussed patients (90%) do not lose consciousness.
Concussion symptoms also don’t always occur immediately after an injury. Symptoms can appear hours to days after the initial injury occurs.
Many concussions do not have any obvious signs, like memory loss, disorientation, confusion, mood changes, dizziness, fatigue, or cognitive problems. Because mTBI patients often do not present any symptoms, a doctor may not order imaging tests. And basic cognitive tests and traditional brain scans might not detect a mild concussion.
Artificial intelligence, however, has the potential to reshape concussion diagnosis.
A scientific team at the University of Southern California (USC) used AI machine learning technology to compare the brain scans of healthy people and injured people and was able to detect which test subjects were concussed and which were not 99% of the time.
“The idea is for this to be a secondary method that can aid the clinician when a patient is exhibiting certain symptoms, but they don’t have a firm concussion diagnosis based solely on cognitive tests,” said USC’s Benjamin Hacker, who led the AI concussion study.
Blood Test Can Diagnose Concussion in 15 Minutes
Advanced imaging techniques, including AI-assisted imaging, are allowing researchers to see smaller and subtler changes in the brain immediately following an injury and to track those changes over time as a patient recovers.
But the “holy grail of brain injury” would be a blood test that could determine concussion severity. That’s according to Dr. Thomas McAllister, a leader of the CARE Consortium, the world’s largest concussion study.
McAllister made his comments in March 2024. In April, the search for his “holy grail” came closer to fruition when the FDA cleared a cartridge designed for use with whole blood that delivers concussion test results in 15 minutes.
Previous blood tests for concussions were only approved for use with blood plasma or serum, requiring samples to be sent to a lab for processing and testing. The new FDA-approved concussion blood test can be delivered at a patient’s bedside and in non-traditional health settings, such as on the sidelines of sporting events.
Abbot’s portable i-STAT Alinity instrument can diagnose a concussion up to 24 hours after injury, according to a manufacturer press release. The press release notes that more than half of people who suspect they have a concussion do not get it checked.
Standard TBI assessment has been the same for decades, relying on a doctor assessment called the Glasgow Coma Scale that assesses a person’s ability to perform eye movements, speak, and move their body.
“Historically, that process for suspected concussions was largely subjective,” said neurosurgeon Dr. Geoffrey Manley. “With the help of this whole blood test, we can quickly and objectively determine whether or not a patient needs a CT scan or additional evaluation, right at the point of care. It’s an incredibly helpful tool that advances the treatment of traumatic brain injury.”
Dr. McAllister says that certain biomarkers show up in the blood within hours of someone suffering a concussion, and the amount measurable in the blood correlates with impact severity. Abbot’s device is not quite the “holy grail” that he envisions, but a future version of the test could measure blood biomarker elevations that correlate with brain injury severity.
The U.S. Army praised the whole blood rapid test as one of the most significant advancements in the care of TBI patients in the past 20 years. During a combat operation, field medics will be able to quickly assess service members for suspected concussions.
Combat troops and contact sport participants are at high risk of concussions and other TBIs, but anyone can suffer a concussion from routine accidents. Only 3% of concussions evaluated at the ER are sports-related. Falls (49%) and motor vehicle collisions (20%) are the most common sources of TBI.
A common concussion myth is that you have to be hit on the head, but concussions can occur when there is a sudden jolt to the body, such as in a slip and fall or a car accident.
Researchers are also learning that susceptibility to brain injury is highly individualized. An identical impact can cause a concussion in one person and not in another.
We are not far off from a future where a car accident victim suspected of having a concussion undergoes a blood test in the ambulance on the way to the hospital to determine if they need a CT scan or additional evaluation upon arrival. Once at the ER, they might then receive an AI imaging test to complete their diagnosis.
Don’t Let the Insurance Company Play Head Games
An insurance company will typically deny an injury claim that does not have supporting medical documentation. Greater understanding and awareness of concussions, and a better ability to diagnose them, is making it harder for insurers to get away with ignoring concussion injury claims.
Science is on your side when it comes to diagnosing a concussion and proving related losses. The TBI injury lawyers at Jim Adler & Associates are on your side, too. If you suffered a head injury and the insurance company tries to deny your claim, call or contact Jim “The Texas Hammer” Adler for a free case review.
