TBI Diagnostics

Diagnostics (Dx): We screen all patients that come to our clinic that has been in a personal injury to either rule out or confirm that a TBI has occurred. We used the following diagnostic tools to screen our patients. These tools are also used to track their treatment progress.

Videonystagmography (VNG): The VNG is a test of the inner ear and portions of the brain. The VNG can help determine the cause of your neurological problem that has resulted from a TBI. Before the test, it is vital to ensure that a good night sleep is achieved to get the most accurate results. The ears may need to be cleared of wax build-up before the exam. During the test, special goggles will be placed over the patient’s eyes to record their eye movements. Since the eyes are directly connected to the brain via the optic nerve the VNG can help pinpoint, in a non-invasive way, where the TBI has occurred. In some the need to use surface electrodes applied around the eyes if the eyes were injured during the accident.

During the test, patients will be instructed to look at and track a lighted target. This will take place and recorded while the patient is lying in various positions. The last part of the tests is where the patient’s ears will be stimulated with warm and cool air to measure the response.

The whole test takes about one to two hours. There is generally little to no discomfort during the test. Certain parts of the examination may make the patient feel dizzy, but this dizziness subsides quickly. Each step of the test will be explained to the patient before and during the testing.

The entire test is conducted at the clinic and can generally be done the same day it is scheduled. The results will be interpreted by the medical provider which will help them either structure the customized treatment plan for the patient or may direct the provider to conduct further testing with an imaging center.

Structural Scans (CT): A computerized tomography (CT) scan combines a series of X-ray images taken from different angles around the body and uses computer processing to create cross-sectional images (slices) of the bones, blood vessels and soft tissues inside the brain. CT scan images provide more- detailed information than plain X-rays do. Similar to an MRI, the patient lays on a table and is automatically fed into the imaging on an automated table. This test is performed by a licensed imaging facility where an appointment is made in advance by the medical provider and then the scan takes place. It typically takes about 30-minutes in total to complete this test.

Functional Scans: There are two subtypes of functional scans. The first test is an electrical test of the brain called electroencephalography (EEG). The second is a SPECT scan which measures the blood flow to the brain. This test is more invasive and requires radioactive dye to be injected into the brain to properly map the function.

QEEG scan: is Quantitative electroencephalography which is a computerized quantitative analysis of the brain waves and other activity. The data comes from the computerized tests in raw EEG data. Electrodes are placed on the head while the patient lays on their lays in a comfortable reclining chair. The QEEG takes about 30-60 minutes to conduct. Once the test is completed it will provide an electrical mapping of the brain which will help pinpoint the area of the brain that may have been affected by the TBI.

SPECT scan: The patient sits in a dark quiet room that is dimly lit. The patient is injected with a radioisotope called Ceretc. Once injected the scan takes approximately 30 to 60 minutes. Once the scan is completed the computer translates the collected data into both 2-D and 3-D images of the brain. These images very helpful to the clinician because it can be pinpointed to the areas of the brain that were damaged and can even measure the specific area. The downside of this type of scan is it is very expensive. This is typically ordered if the VNG testing isn’t able to pinpoint the area of the brain that was damaged.

Once the affected area(s) of the brain are determined to have been impacted by the personal injury the medical provider can then customize a treatment plan to optimize the healing process.

Treatments

Some of the treatments that we offer are included below, but a comprehensive list is not available here. Regenerative Medicine: Regenerative medicine is defined as the study of self-healing, as well as tissue engineering. Stem cells are a key part of this process. There are a variety of applications for this field of medicine.

Oxygen Therapy: Vestibular therapy is the retraining of the brain to differentiate signals coming from the eyes and the inner ear. The reason for this is that when somebody gets a concussion or swelling in the brain, the brain tries to overcompensate using both systems at the same time and gets used to that. When the signals mix, it causes the patient to have confusion, dizziness, and loss of balance due to the many signals firing at the same time. Vestibular therapy teaches the brain to differentiate those signals making it easier for the patient to process, instead of being too overwhelmed. It also teaches both the eyes and the Vestibular system to work separately.

Vestibular Therapy: is the retraining of the brain to differentiate signals coming from the eyes and the inner ear. The reason for this is that when somebody gets a concussion or swelling in the brain, the brain tries to overcompensate using both systems at the same time and gets used to that. When the signals mix, it causes the patient to have confusion, dizziness, and loss of balance due to the many signals firing at the same time. Vestibular therapy teaches the brain to differentiate those signals making it easier for the patient to process, instead of being too overwhelmed. It also teaches both the eyes and the Vestibular system to work separately.

Pharmacotherapy: Medications that have shown efficacy in patients will often be prescribed to promote the healing of the brain and reduce symptoms associated with the TBI. Nutritional Supplementation Therapy: The brain uses the most energy out of all the organs in the body. When damage to the brain occurs through a TBI the resources needed to repair itself goes into overdrive. Therefore, nutrition plans and supplementation are structured to promote the healing process.