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This article critically examines divergent diagnostic criteria for mild traumatic brain injury (mTBI) used across clinical and forensic settings, including ACRM, VA/DoD, DSM-5-TR, ICD-11, and CISG frameworks, highlighting their differing evidentiary standards and practical limitations. The authors review evidence-based approaches to diagnostic uncertainty, emerging blood biomarkers (GFAP, UCH-L1, NfL, S100B), and the scope of neuropsychological opinion in legal contexts, addressing challenges in retrospective determination and mechanistic complexity in injury mechanisms.