Chiropractor Meridian ID Spencer Zimmerman How Is A Concussion Diagnosed

Did I suffer a concussion, this is a question that millions ask each and every year.

In this article, our Meridian ID chiropractor is going to review the latest criteria for diagnosing a concussion as of May 2023.

Before we go into that, we first are going to start by discussing concussion statistics.


In the United States, it is estimated there are at least 6-7 million concussions that occur each and every year. Over 2.5 million concussions occur in sports alone (1).

To compare this to cancer. All cancer diagnoses made each year are less than the total amount of concussions. Yet, cancer is routinely talked about significantly more than concussions.

It is estimated that 10-20% of all high school athletes that play a contact sport will suffer a concussion and nearly 50% of these aren’t reported or diagnosed.

A study out of Israel found that 25% of children who suffered a concussion were not diagnosed and instead were told they had depression, anxiety, ADHD, insomnia, and other similar labels.

Lastly, of those who are diagnosed with a concussion nearly 50% are still suffering after a year. So this injury that was considered harmless only 10 years ago seems to be anything but that.

I hope by this point you see how frequently concussions occur and why it is not only important to get a correct diagnosis but also to receive proper care from the very beginning.


Recently new criteria were published by The American Congress of Rehabilitation Medicine (2).

There are 6 criteria that are used, but these don’t all have to be there to receive a diagnosis. To better understand this here is the diagram that was published as part of the paper (1).

I’ll try to make it easy to follow.

Criteria 1 + 2= Concussion as long as criteria 6 is normal
Criteria 1 + 3 + 4= Concussion as long as criteria 6 is normal
Criteria 1 + 5= Concussion


Criteria 1: Is there an appropriate mechanism of injury?
Plausible causes of injury include car accidents, slips and falls, physical violence, whiplash injury, and blast injuries. This doesn’t have to be a direct blow to the head, but an oscillation through the body that impacts the brain is sufficient.

This part must absolutely be there, if this isn’t present then one cannot meet the criteria for a concussion.

Criteria 2: Clinical Signs
Were any of the following presents at the time of injury:

  • Loss of consciousness
  • Altered mental state
  • Confusion
  • Posturing or gross instability

If any of these are present plus the appropriate mechanism of injury this would be a concussion.

Criteria 3: Acute Symptoms
Are any of these symptoms new or worsened since compared to before the injury? These symptoms fall under subjective mental alterations, physical, cognitive, and emotional categories. You need a total of 2 of the symptoms.

  • Subjective Mental Alterations: Confused, dazed, or disoriented
  • Physical: Headaches, nausea, dizziness, balance, vision, light or noise sensitivity
  • Cognitive: Feeling slow, mental fog, difficulty concentration, and memory
  • Emotional: Irritable, angry, or uncharacteristically emotional lability

Criteria 4: Evaluation
All possible concussions that have the appropriate mechanism of injury and 2 or more symptoms should have a comprehensive evaluation.

Evaluation should test cognition, balance, and oculomotor (eye movement) function. You can have problems with any of the testing or simply an

increase of symptoms when doing eye movement testing to have this be a positive result.

Criteria 5: Imaging
If imaging findings of a brain injury are present then criteria will be met with proper mechanism of injury. Most concussions with routine MRI or CT scans will be normal. Don’t worry if that is the case for you as it should never exclude the possibility of a concussion.

Criteria 6: Not better accounted for by confounding factors
In some cases, these symptoms and evaluation findings can be from drug use, medications, sleep deprivation, psychosis, and other things.


At this point, we have reviewed what is able to cause a concussion, its symptoms, and what testing should be done to make the diagnosis.

It is essential to get a proper evaluation as I routinely see individuals that should have been diagnosed but because they had a brief evaluation they weren’t diagnosed and ultimately didn’t receive the proper treatment.

If you are ready to take control of your recovery or to find out if a concussion may be the cause of your symptoms then reach out today to get started.


  2. Silverberg, N. D., Iverson, G. L., ACRM Brain Injury Special Interest Group Mild TBI Task Force and the ACRM Mild TBI Definition Expert Consensus Group, ACRM Brain Injury Special Interest Group Mild TBI Task Force members, Cogan, A., Dams-O’Connor, K., Delmonico, R., Graf, M. J. P., Iaccarino, M. A., Kajankova, M., Kamins, J., McCulloch, K. L., McKinney, G., Nagele, D.,
  3. Panenka, W. J., Rabinowitz, A. R., Reed, N., Wethe, J. V., Whitehair, V., ACRM Mild TBI Diagnostic Criteria Expert Consensus Group, Anderson, V., … Zemek, R. (2023). The American Congress of Rehabilitation Medicine Diagnostic Criteria for Mild Traumatic Brain Injury. Archives of physical medicine and rehabilitation, S0003-9993(23)00297-6. Advance online publication.