Post-concussion symptoms after a negative CT scan?


A CT scan for post-concussion symptoms

When you experience post-concussion symptoms after a negative CT scan, this can be really confusing. Doctors may tell you that nothing is wrong, because there are no abnormalities on the brain scan. However, you can feel something is off.

Table of contents:
A CT scan for concussions
Post-concussion symptoms and CT results 
Concussion injury on a microscopic scale

A CT scan for concussions

After a concussion, a medical imaging test can be performed. Mostly, this is a CT-scan of the brain.

Concussion symptoms calling for a CT scan

Making a CT-scan is chosen depending on a set of parameters. For example, in case you need to vomit, experience post-traumatic amnesia or have speech, vision or hearing problems.

This doctor explains it well:

Source: Norton Healthcare

CT scans and concussion diagnosis

CT-scans can reveal brain damage, but this is not always the case for mild TBI. In fact, about 90% of the CT-scans after experiencing mTBI do not show abnormalities.

So, CT abnormalities can prove that there is something off in the brain. But a positive CT diagnosis is not a necessity for explaining your symptoms after sustaining a concussion. You might find it reassuring to know that this has also been confirmed in research recently.

Post-concussion symptoms and CT results 

Post-concussion symptoms are rarely seen by CT

If your CT scan was clean, could you experience just as many post-concussion symptoms as someone with visible abnormalities? Or do visible abnormalities in brain scans actually lead to worse disease outcomes? 

For example, do patients with a positive CT scan suffer from more severe concussion effects or experience more long term effects of a concussion?

CENTER-TBI research

Recent research focused on this question. CENTER-TBI is a large European research project on traumatic brain injury.  

Exciting news: we are going to interview several of their researchers in future Concussion Stories episodes!

Positive or negative CT scans

The researchers divided their research subjects into two groups:

  1. patients having complicated mTBI (visible injury on CT-scans, so a positive scan)
  2. and patients having uncomplicated mTBI (no visible abnormalities, so a negative scan)

Concussion effects lasted for both groups

 The CENTER-TBI study showed that patients with complicated mTBI reported slightly more concussion after effects and more post-concussion syndrome symptoms at 3 and 6 months. 

However, these differences are quite small and can also be ascribed to variations in patient characteristics. 

The researchers concluded that the CT scan result could not really predict whether or not someone was going to experience concussion symptoms months later. 

CT-negative and concussion symptoms

Thus, having a clean CT scan means that…

  1. you have practically the same possibility to experience concussion effects
  2. and you have practically the same possibility of having PCS symptoms

…as when your CT scan would have shown complicated mTBI.

Concussion injury on a microscopic scale

Concussion injury on a microscopic scale

The cause of your symptoms doesn’t need to be identifiable by a doctor. This doesn’t make it any more logical to feel what you feel. 

As you may recall from earlier blogs, mTBI involves damage on a microscopic scale. This is often too small to be visible on brain scans. Researchers working in the CENTER-TBI group are working hard to clarify as much and as soon as possible.

You are your own best doctor

It can be frustrating not knowing what is exactly wrong in your brain. But remember, you yourself are the best indicator for how you feel. Listen to your body and be kind to yourself. Also, if you’re looking to get action: have a look at 3 things you can do right now to help your brain recover faster.

We’d love to hear from you

What do you take away from this blog post? Share your experience in the comments down below.

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  1. John Rankin

    I was involved in a major head on collision about 7 weeks ago. still having headaches, nausea & dizziness, even though my CT scan was “normal”. A large vehicle (Lincoln Navigator) rolled thru a stop sign – I had the right of way & was traveling at 55MPH. When the vehicle rolled thru the stop ( he had slowed to stop, but was looking at his lap and rolled thru the stop at about 6 or 7MPH) I had about 1 second or less to react. I hit the brake, slammed into the other vehicle at 50MPH.The impact knocked me unconscious – when I came to, I was rolling at about 3MPH, in the opposite lane, airbag in my lap, cabin filled with smoke.

    To look at me, there was very little visible signs that I had been in such a wreck. I was driving a Chevy Silverado, which likely saved my life. But since the wreck, I’ve had blurred vision, headaches, dizziness, memory loss, light sensitivity, loss of balance, fatigue, etc. The nausea has led to vomiting, a little over 4 weeks after the wreck, and today, as soon as I stood on my feet in the morning, the nausea was very bad, very close to vomiting. Very frustrating.

    • Melanie

      Dear John, this has been an awful accident! And I’m sorry to read about the symptoms you’ve experienced since then and how you’re feeling right now. Have you visited a hospital to get scans and neurological tests done?

  2. Kristi Zmak

    I have a question. Hope it’s okay to ask a question. I fell and hit my head to the point of my head bouncing. I went to the emergency room and had a CT scan that came out normal. Injury was 3 weeks ago. I am still having symptoms such as dizziness headaches, double vision, confusion, etc… Should I be concerned?

    • Melanie

      Dear Kristi, thank you for reaching out. I am sorry to read that you are experiencing concussion symptoms. It’s completely normal for a CT scan (or MRI scan for that matter) not to be able to identify a mild traumatic brain injury. The symptoms you are experiencing are a far better means of diagnosis: it is likely that you sustained a concussion. You shouldn’t be concerned in the sense that concern and worry only add to your issues. You do, however, want to direct your attention toward healing <3 Please find this post about what I believe is the best concussion treatment, and also the resources page to find many materials I made to help you move forward. With love, Melanie


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