The evaluation of a concussion begins with a history and physical exam.

Physical findings in someone with a concussion may include:

• Blood behind the eardrum:
• May be a sign of basilar skull fracture
• Bruising behind the ear or around both eyes:
• May be a sign of basilar skull fracture
• Clear fluid leaking from the nose:
• A sign of basilar skull fracture
• Large scalp contusion
• Neck tenderness
• Skull deformity:
• A depressed area on the skull
• Visible skull fracture through a scalp wound

Physical findings on a neurologic exam may include:

• Abnormal eye muscle exam
• Abnormal eye pupil exam
• Amnesia
• Arm numbness (unilateral)
• Arm weakness (unilateral)
• Confusion
• Difficulty speaking
• Difficulty walking
• Leg numbness (unilateral)
• Leg weakness (unilateral)
• Weakness on one side of the body
• Numbness on one side of the body
• Loss of consciousness
• Papilledema:
• Evidence of increased brain pressure on eye exam
• Seizure

Testing may be necessary to determine the extent of the brain injury.

Tests that may be used to evaluate concussion include:

• Skull x-rays
• CT scan of the brain
• MRI scan of the brain
• X-rays of the neck:
• Normal cervical spine
• Torn ligaments
• Fracture of the odontoid process of the second vertebra
• Fracture of a vertebral body
• Fracture of a spinous process in the back of a neck vertebra