This "window" has been broken down into varying time frames according to age and the severity of the injury, by new draft guidelines from the National Institute for Health and Care Excellence (NICE).

Children and adults with a potentially serious or life-threatening head injury should be administered a CT brain scan within one hour, while others should be scanned within four to eight hours of their injury depending on the injury, the new guidelines state. Currently, NICE suggests a time frame of eight hours for anyone to be scanned.


The new head injury guidelines are subject to review and are expected to be published in January 2014.

Guidelines are tightening in the sports world too. Because of recent evidence and attention given to brain concussions in sports, the NFL now mandates following a protocol of evaluation and treatment following any suspected brain concussion. For example, the NFL used to simply rely on the team physician to clear a player to return to the game. While the NFL has not fully solidified its protocol as yet, they have adopted a policy of requiring at least two professionals to provide clearance, one of whom is not affiliated with the team. Also, it is unlikely that any NFL players will continue to be released for play on the same day concussion occurs.

Preventive measures
A TBI can occur on the athletic field, battlefield, on the playground, in a car accident or even at home. And anyone involved in a physical work activity is at high risk of injury.

"The single most hazardous thing we do is get in an automobile," said Hammeke. "In football, there are strategies associated with avoiding head-to-head contact that will reduce concussions."

Wearing the proper protective headgear when playing contact sports is an obvious but important preventative measure, said Carestream's Burns. This is also true when working around the house or in a job that demands proper head protection.

"For example, if you are pruning a tree at home, wearing a hardhat is a smart choice," Burns said.

Although recent studies have uncovered more information about the effects of concussions on the brain, and there have been advances in imaging techniques for diagnosing and treating TBIs, vigilance for hazardous situations is optimal. Even with all of these efforts, considerable mystery still surrounds the total impact of a concussion on the brain and the prime way to treat it.

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