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Traumatic Brain Injury - Dizziness

Karns & Kerrison

People that suffer from a traumatic brain injury suffer multiple symptoms that can include post-traumatic dizziness or vertigo. These symptoms of dizziness occur in a large percentage of the cases in addition to other symptoms including cognitive problems, behavioral problems and physical impairments. Post-traumatic dizziness or vertigo has obvious symptoms of feeling like your head is spinning or losing your balance. The same force that causes the traumatic brain injury such as a blow to the head or coup - contracoup (the shaking of the head back and forth or sideways) can cause post-traumatic dizziness.

When the traumatic brain injury occurs, there are different injuries that can occur inside the inner ear that cause post-traumatic dizziness. These injuries include:

  1. Benign paroxysmal positional vertigo, which occurs when trauma moves the crystals in the inner ear out of place causing brief episodes of mild to intense dizziness. These symptoms can occur with changes in head position when tipping your head or lying down or sitting up in bed.
  2. Labyrinthine concussion, which is injury to the inner ear causing nerve damage in the vestibular system causing dizziness.
  3. Traumatic endolymphatic hydrops occurs when there is a disruption of fluid in the inner ear. This condition can be created with trauma and is also known as Meniere's syndrome.
  4. Temporal bone fracture in the area of the ear-drum can cause dizziness.
  5. Fistula damage is when the membrane is damaged between the inner ear and middle ear causing dizziness.
  6. Cervical injuries - injuries to the neck caused during traumatic brain injury can cause dizziness when there is vascular compression.
  7. Some medications taken during treatment for traumatic brain injury can cause dizziness.

Treatment for these injuries causing post-traumatic dizziness depends on the diagnosis of which problem (as above listed).

Physical therapy specific to being the problem of the displaced crystals in benign paroxysmal positional vertigo (BPPV) is known as the Epley Maneuver and is done with the assistance of a physical therapist moving the head in different positions causing the crystals to go back into the correct area stopping the dizziness. This type of therapy can be learned and done at home during the flare-up of the dizziness. In addition, physical therapy for the cervical area can help with dizziness from cervical injuries.

Another type of treatment would be medication to help with fluid problems in the inner ear causing dizziness or nerve problems in the inner ear causing dizziness.

Post-traumatic brain injury can cause post-traumatic dizziness or vertigo and the exact injury causing the post-traumatic dizziness must be diagnosed to be properly treated.

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