MACE Concussion Assessment & Screening 2 — Questions and Answers
Question 1: What is the difference between the MACE and a definitive TBI diagnosis?
- The MACE is a screening tool that identifies potential concussion; a definitive diagnosis requires comprehensive medical evaluation by a qualified provider (Correct answer)
- The MACE provides a definitive diagnosis
- They are the same thing
- The MACE replaces the need for medical evaluation
Correct answer: The MACE is a screening tool that identifies potential concussion; a definitive diagnosis requires comprehensive medical evaluation by a qualified provider
The MACE is a screening instrument, not a diagnostic tool. Abnormal results indicate the need for further evaluation by a medical officer, which may include imaging, neuropsychological testing, and specialist consultation.
Question 2: How is the immediate memory subtest of the MACE administered?
- The examiner reads a list of 5 words and asks the service member to repeat as many as possible, repeated over 3 trials (Correct answer)
- The service member reads a passage aloud
- The examiner shows pictures for identification
- The service member writes their autobiography
Correct answer: The examiner reads a list of 5 words and asks the service member to repeat as many as possible, repeated over 3 trials
Immediate memory uses a 5-word list read aloud by the examiner. The service member repeats as many words as possible. This is repeated for 3 trials to assess encoding and immediate recall ability.
Question 3: What does the concentration subtest of the MACE assess?
- Sustained attention and working memory through reverse digit recall and months backward tasks (Correct answer)
- Physical endurance
- Visual acuity
- Emotional stability
Correct answer: Sustained attention and working memory through reverse digit recall and months backward tasks
The concentration subtest uses reverse digit span (repeating numbers backward) and months backward tasks to evaluate attention, concentration, and working memory—cognitive functions commonly disrupted by concussion.
Question 4: Why is delayed recall an important component of the MACE?
- It assesses memory consolidation by testing whether words learned earlier can be retrieved after a time delay, revealing hippocampal function (Correct answer)
- It tests physical reaction time
- It measures hearing ability
- It evaluates emotional coping
Correct answer: It assesses memory consolidation by testing whether words learned earlier can be retrieved after a time delay, revealing hippocampal function
Delayed recall evaluates the brain's ability to store and retrieve information over time. Concussion often impairs memory consolidation, making this subtest particularly sensitive to mild traumatic brain injury.
Question 5: What are the red flag symptoms that require immediate medical evacuation during MACE assessment?
- Unequal pupils, worsening headache, seizures, repeated vomiting, increasing confusion, or weakness on one side of the body (Correct answer)
- Mild headache
- Feeling tired
- Mild dizziness that resolves quickly
Correct answer: Unequal pupils, worsening headache, seizures, repeated vomiting, increasing confusion, or weakness on one side of the body
Red flag symptoms may indicate more severe brain injury (intracranial hemorrhage, skull fracture) requiring emergency imaging and neurosurgical intervention. These findings override the MACE and mandate immediate evacuation.
Question 6: How should the MACE be documented and reported?
- Results must be recorded on the official MACE form, included in the service member's medical record, and reported through the chain of command per service policy (Correct answer)
- Results are verbal only
- Documentation is optional
- Only abnormal results need documentation
Correct answer: Results must be recorded on the official MACE form, included in the service member's medical record, and reported through the chain of command per service policy
Complete MACE documentation includes the date, time, mechanism of injury, all subtest scores, neurological screening results, and clinical recommendations. This documentation supports medical tracking and return-to-duty decisions.
MACE Concussion Assessment & Screening 2
What is the difference between the MACE and a definitive TBI diagnosis?