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Traumatic brain injury (TBI) has become widely recognized as a formidable medical problem around the world, causing much suffering and lasting disability in many patients.1 Despite the high prevalence of this disorder, however, diagnosis remains imprecise in many cases because no blood, neuroimaging, or other test reliably establishes whether a TBI has actually occurred. The frequently encountered clinical problem of mild TBI can present a particularly vexing diagnostic obstacle because reliable information about the presumed causative event and its clinical sequelae may be lacking. Even moderate and severe TBI—usually easier to appreciate because of signs of cranial or facial trauma—can be difficult to identify and distinguish on clinical grounds. In view of these uncertainties, a pressing need exists for a readily available clinical test that can permit accurate diagnosis of TBI and monitoring of outcome over time.
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