Yes, and this is one of the most common misconceptions in PI cases involving head injury. Standard CT and MRI scans are designed to detect structural damage like bleeding or fractures. They are not designed to detect the functional changes that occur with concussion or mild TBI.

A normal scan does not rule out a real, testable injury. It simply means the imaging that was used was not the right tool for the question being asked. Objective testing such as neuropsychological evaluation and oculomotor or oculo-vestibular assessment can identify functional deficits that imaging cannot capture, which is often the missing piece in cases where a client is reporting real symptoms despite unremarkable scans. Our practical evaluation workflow for when imaging is negative walks through how clinicians approach this.

If your client has ongoing symptoms after a normal CT or MRI, that is a strong reason to refer, not a reason to hold off.