Keystone Medical Group

Comprehensive Concussion Evaluation in Kansas City

A concussion is a complex brain injury that can affect memory, balance, cognition, and overall daily functioning. At Keystone Medical Group in Kansas City, we provide comprehensive concussion evaluations to accurately assess symptoms, identify underlying issues, and guide a personalized recovery plan. Our evidence-based approach ensures that every patient receives a thorough assessment, helping to track progress, manage symptoms, and support a safe return to work, school, or daily activities. We proudly serve patients in Kansas City and surrounding areas, including Overland Park, Lee’s Summit, North Kansas City, Raytown, and Liberty.

Below, we outline our approach and the various options we use to determine the root cause of the symptoms, given the complexity of concussions, and how these findings inform our therapy recommendations tailored to your needs.

Why Choose Keystone Medical Group

  • Experienced clinicians specializing in concussion management and brain injury care

  • Evidence-based evaluation methods and personalized treatment plans

  • Integrated care combining neurological, physical, and cognitive rehabilitation

  • Serving Kansas City and surrounding communities, including Overland Park, Lee’s Summit, North Kansas City, Raytown, and Liberty

Benefits of a Concussion Evaluation

  • Provides a clear understanding of your symptoms and brain function

  • Identifies cognitive, physical, or emotional impairments

  • Guides a personalized treatment and recovery plan

  • Reduces the risk of prolonged or repeated injuries

  • Supports a safe return to work, school, or sports activities

Our Approach

1. Concussion Symptom Questionnaire

The first step in our concussion evaluation process is to have the patient complete a comprehensive concussion symptom questionnaire. In this questionnaire, patients score each symptom on a scale from 0 to 5, where 0 means they do not experience the symptom at all, and 5 indicates the symptom is severe. This self-assessment covers a wide range of common concussion symptoms—such as headaches, dizziness, fatigue, and concentration difficulties—and provides our providers with an initial snapshot of the patient’s current symptom burden.

This scoring system helps our providers in several ways. It allows us to identify which symptoms are most impacting the patient, track symptom patterns over time, and prioritize focus areas for evaluation and treatment. By gathering this baseline data, we can tailor our diagnostic approach to the patient’s specific needs and monitor their progress through subsequent assessments. This personalized insight is essential for creating an effective, targeted treatment plan.

Post-concussion syndrome Kansas City

2. Detailed History

Concussion rehabilitation Kansas City

During your initial concussion evaluation, we take a personalized approach to gather essential information for diagnosis and treatment. We begin with a detailed injury history, including how and when the concussion occurred, the mechanism of injury (e.g., impact, whiplash, or sports), and immediate symptoms. We then review all symptoms, noting their frequency, intensity, and any recent changes in severity.

Next, we discuss your treatment history, including past therapies and medications, and their effectiveness. We also examine your medical history, including any prior concussions or neurological conditions, as well as issues like migraines or vestibular disorders. Additionally, we assess how the concussion affects your daily life, including work, sleep, and social activities, and review relevant medical records, such as past imaging studies or tests.

Finally, we address your goals and concerns about recovery and any changes since the injury. Your subjective input on progress is crucial, helping us form a comprehensive understanding of your situation. This thorough history allows us to design a personalized treatment plan tailored to your specific needs.

3. Cranial Nerve Evaluation

Cranial nerves are a set of twelve nerves that emerge directly from the brain, rather than from the spinal cord. They play a critical role in controlling essential functions, such as eye movement, facial sensation, taste, swallowing, hearing, and balance. Each cranial nerve has a specific role, whether in transmitting sensory information (like sight or smell) or controlling muscles (like those that move the eyes or enable facial expressions). Because they directly connect to the brain, these nerves can be affected by traumatic brain injuries, including concussions.

During a cranial nerve evaluation, our providers test each of these twelve nerves to assess their function. This might involve observing eye movement to check for tracking and coordination, testing facial muscle strength, examining reflexes, or assessing hearing and balance. For instance, the oculomotor, trochlear, and abducens nerves control eye movement, and any impairment in these can result in symptoms like double vision or difficulty focusing, which are common in concussion cases.

This examination helps us distinguish whether the injury affects specific cranial nerves, the brain itself, or both. If we find that certain cranial nerves are compromised, it may suggest direct injury to those nerves or pressure on the nerve pathways. Alternatively, if multiple cranial nerves and brain functions are impacted, this could indicate a more generalized brain injury, which is typical in diffuse injuries like concussions. By isolating the affected areas, our cranial nerve exam provides a clearer map of injury patterns, helping us to design a more targeted treatment plan.

Concussion specialists near me Kansas City

4. Cervical Spine Evaluation

Concussion evaluation Kansas City

Examining the cervical spine during a concussion evaluation is crucial, as nearly all concussions involve some form of cervical injury. The neck plays an essential role in supporting the head and facilitating movement, and due to the common mechanisms of concussion—such as whiplash or rapid head movement—the cervical spine often sustains injuries like muscle strain, ligament sprains, or joint dysfunction. These injuries can worsen symptoms such as headaches, dizziness, and neck pain.

The cervical spine is also key to proprioception (the body’s ability to sense its position in space) and gaze stabilization (keeping the visual field steady while moving the head). When the neck is injured, these processes can be disrupted, leading to balance issues, coordination difficulties, and blurred vision, which make tasks like reading, driving, or walking challenging.

During the evaluation, we assess the cervical spine by testing range of motion, muscle tightness, spasms, and joint mobility. Identifying areas of restriction or discomfort helps us determine if cervical issues are contributing to symptoms. By addressing these cervical injuries, we can help alleviate symptoms, reduce discomfort, and improve both brain and neck function, leading to a more effective recovery overall.

5. Advanced Imaging

Advanced imaging plays a vital role in evaluating concussed patients, especially when traditional imaging methods, like standard MRI or CT scans, may not provide sufficient insight into the extent of injury. For patients with mild traumatic brain injuries (mTBI), including concussions, these traditional imaging techniques often fail to show significant changes, even though brain function may be impaired. This is where advanced imaging, such as MRI with Diffusion Tensor Imaging (DTI), becomes crucial.

DTI is a specialized type of MRI that is far more sensitive than standard imaging in detecting subtle changes in brain structure, particularly in the white matter. White matter consists of nerve fibers that transmit signals between different regions of the brain, and in concussions, these fibers can be damaged, leading to changes in brain function. DTI can detect this microstructural damage by mapping the movement of water molecules along these fibers, helping to identify areas of injury that traditional MRI may miss.

As part of our comprehensive concussion evaluation, we review any previous imaging studies the patient may have had, and based on the clinical presentation, we may order additional scans, typically an MRI with DTI. This allows us to gather a clearer picture of the brain’s condition, which helps guide treatment decisions. By identifying areas of damage that may not be visible on standard MRI, DTI provides essential information for accurately diagnosing and managing concussion-related symptoms.

Kansas City concussion rehabilitation clinic

6. Computer-Based Neurocognitive Testing

Concussion Evaluation and Treatment Kansas City

Computer-based neurocognitive testing, such as CNS Vital Signs, is an essential tool in evaluating cognitive function after a concussion. This type of testing uses computerized assessments to measure a variety of cognitive skills, including attention, memory, processing speed, and executive function. Unlike traditional testing methods, which can be subjective or dependent on self-reporting, neurocognitive tests provide objective, quantifiable data that can be tracked over time.

At our clinic, we use CNS Vital Signs to assess baseline cognitive function and monitor changes throughout the recovery process. The tests are designed to detect subtle impairments that may not be immediately obvious but are critical to a concussion diagnosis. By comparing a patient’s results to normative data, we can identify specific areas where the patient is struggling, such as in memory recall or processing speed. These areas of weakness are particularly important in guiding therapy, as they can point to the underlying cognitive deficits caused by the concussion.

As the patient progresses, we use follow-up neurocognitive testing to track improvements or identify any ongoing challenges. This data is invaluable in adjusting treatment plans, ensuring that therapy targets the areas of cognitive function that need the most attention. Whether it’s addressing memory issues, improving focus, or enhancing processing speed, the insights gained from CNS Vital Signs help us tailor therapies to each patient’s specific needs, ensuring the most effective and personalized approach to recovery.

7. Electroencephalography (EEG)

EEG, or electroencephalography, is a diagnostic tool that measures the brain’s electrical activity. Small electrodes are placed on the scalp to detect and record the brain’s electrical impulses, allowing real-time monitoring of brain function. This method helps identify and analyze brain wave patterns, which can reveal abnormalities indicative of neurological conditions such as concussions or traumatic brain injury (TBI).

In the case of concussions, EEG is valuable because it can detect changes in brain wave patterns that may not be visible through traditional imaging techniques like CT scans or MRIs. While these imaging methods often miss subtle brain function disruptions in mild TBIs or concussions, EEG can identify electrical irregularities in the brain caused by these injuries. These changes may point to areas of dysfunction and help pinpoint specific regions affected by the concussion.

We utilize BrainView, a specialized EEG system, to assess both concussion and TBI in our patients. BrainView provides advanced analysis of brain wave activity, helping us detect abnormal patterns that are indicative of brain injury. This data is instrumental in confirming a concussion diagnosis, assessing the severity of the injury, and guiding treatment strategies. Additionally, EEG data allows us to track recovery over time, monitoring improvements or ongoing issues with brain function. This helps ensure that our therapies are aligned with the patient’s unique needs and progress.

 

 
 
Workers' Compensation Injury Rehabilitation Kansas City

8. Neurotrauma Assessment Test

Concussion treatment services Kansas City

The Neurotrauma Assessment Test (NAT) is a cutting-edge tool that detects specific proteins, known as biomarkers, which are released into the bloodstream when the brain or spinal cord is injured. These biomarkers, such as GFAP (glial fibrillary acidic protein), serve as indicators of injury severity. After a traumatic brain injury (TBI), these proteins quickly appear in the blood, with some persisting and remaining detectable for months.

Measuring TBI biomarkers provides valuable insights into the extent of brain injury, yet they are only one part of a comprehensive evaluation. Other diagnostic tools, such as CT scans or MRIs, may still be necessary for a full understanding of the injury’s impact. Biomarker testing offers unique advantages by providing information on both the type and amount of brain injury, which can help predict outcomes and shape treatment plans.

The study of blood-based biomarkers in TBI is a growing field, with researchers continually identifying and exploring new biomarkers. As our understanding of TBI advances, biomarker blood tests like NAT are expected to become increasingly central to TBI diagnosis and management, offering a powerful tool for guiding care.

9. Vestibular Assessment

The vestibular assessment is a focused evaluation of how the inner ear contributes to balance, spatial orientation, and overall stability, which are often disrupted after a concussion. One important part of this process is positional testing, used to identify conditions such as benign paroxysmal positional vertigo (BPPV). BPPV occurs when small crystals in the inner ear move out of place, causing dizziness during specific head movements. The Dix-Hallpike maneuver is performed to help determine if a patient’s symptoms are related to this condition, allowing us to confirm and address the underlying cause of their dizziness.

In addition to positional testing, vestibulo-ocular reflex (VOR) assessments are used to evaluate how well the eyes and inner ear work together to stabilize vision during head motion. The VOR head impulse test measures a patient’s ability to keep their eyes fixed on a target while their head moves, which can reveal subtle reflex impairments. Dynamic visual acuity testing is also performed, where patients read from an eye chart while moving their heads. If vision blurs, it suggests that head movement is interfering with focus, a common issue linked to vestibular dysfunction after concussion. These combined evaluations provide valuable insight into the specific deficits a patient may be experiencing and guide targeted treatment strategies to reduce dizziness, restore balance, and improve daily function.

Concussion specialists near me Kansas City

10. Oculomotor Assessment

concussion-therapy-Kansas-City

The oculomotor assessment evaluates how the eyes move and coordinate, functions that are often disrupted after a concussion. This testing helps us understand how visual control may be contributing to symptoms such as blurred vision, headaches, or difficulty focusing. One component is smooth pursuit testing, which measures how well the eyes can steadily track a moving object. If eye movements appear jerky or uneven, it may indicate problems with visual tracking and coordination. We also perform saccadic testing, which looks at rapid eye movements between two fixed points to assess processing speed, focus, and attention.

Another important measure is the gaze stability test, which examines the vestibulo-ocular reflex. This reflex allows patients to keep their eyes fixed on a target while the head moves, an essential function for maintaining clear vision during motion. We also check convergence and divergence, which involve shifting focus between near and distant objects to evaluate depth perception and eye teaming. Difficulties in these areas can contribute to double vision, eye strain, or fatigue. By identifying these disruptions, the oculomotor assessment guides targeted therapies that improve visual control, reduce symptoms, and support patients in returning to normal activities with greater comfort and confidence.

11. Balance Assessment

Our balance assessment is a detailed evaluation of stability and sensory integration, both of which are commonly affected after a concussion. We begin with the Romberg test, where the patient stands with feet together, arms at their sides, and eyes closed. By removing visual input, this test highlights how much the body relies on proprioception and vestibular feedback for balance. Any swaying or instability may indicate a sensory integration problem or vestibular dysfunction.

Next, we use the tandem stance, which involves standing heel-to-toe in a straight line. This position places greater demand on the proprioceptive system, particularly when performed on an uneven surface or with eyes closed, and provides insight into the body’s ability to maintain fine motor balance control.

Dynamic balance is then assessed through tandem walking, where the patient walks heel-to-toe along a straight line. This test allows us to observe coordination and gait stability, both of which may be disrupted in individuals recovering from a concussion and can affect daily mobility.

Finally, we administer the Clinical Test of Sensory Integration and Balance, or CTSIB, which evaluates how the visual, vestibular, and proprioceptive systems work together to maintain stability. During this test, patients stand on firm and foam surfaces with both eyes open and closed, helping us determine which systems are compensating for underlying deficits.

Together, these assessments provide valuable insight into a patient’s balance function and guide us in creating targeted treatment strategies to improve stability, reduce dizziness, and support overall recovery following a concussion.

Best concussion treatment Kansas City

12. Mental Health Assessment

Our mental health assessment is an important part of a comprehensive concussion evaluation, as emotional and psychological changes are often overlooked after head injuries. Many patients experience symptoms such as irritability, anxiety, depression, mood swings, or difficulty handling stress, which can significantly affect recovery and daily function.

During the assessment, we explore emotional well-being through structured questionnaires, interviews, and symptom checklists designed to identify changes in mood, thought patterns, and stress tolerance. These tools provide valuable insight into whether symptoms are directly related to the concussion, a pre-existing condition, or the stress of managing ongoing health challenges.

We also evaluate cognitive-emotional interactions, since issues like poor sleep, fatigue, or memory difficulties can intensify mood disturbances. Understanding how these factors overlap helps create a clearer picture of each patient’s overall health.

Because we have a licensed therapist on our team, patients can receive direct counseling and therapeutic support as part of their recovery plan. This integration ensures that both physical healing and emotional well-being are addressed together, giving patients the best opportunity for long-term success.

By addressing mental health as part of concussion care, we help patients restore balance in their daily lives, improve resilience, and reduce the risk of prolonged symptoms.

mental health therapy after a car accident

We are Experts in Accident Care

Car Accidents

We specialize in treating a range of injuries caused by car accidents, including whiplash, head injuries, lower back pain, shoulder injuries, and spinal injuries resulting from motor vehicle collisions.

Motorcycle Accidents

We offer a specialized network comprising imaging centers, orthopedic surgeons, and other specialists, particularly for cases involving more severe injuries.

Truck Accidents

In the event of truck accidents where insurance coverage falls short for medical expenses, we can connect you with appropriate legal representation tailored to your specific circumstances.

Work Accidents

Our established treatment protocol for injuries is designed to expedite your recovery, ensuring you return to full capacity as soon as possible, minimizing any work disruptions.

Slip and Fall

Slip and fall cases can be complex, especially when disputes arise concerning liability and coverage. Rest assured, we are well-versed in navigating these intricacies to ensure your case is handled with expertise and diligence.