Labyrinthine or Cortical Concussion
What is the relationship between dizziness, vertigo, and concussion?
Feeling dizzy, lightheaded, or like the room is spinning/moving are common symptoms following head injuries like a concussion. The symptoms can resolve, or can become persistent and debilitating for some patients. The symptoms can be caused by brain injury (cortical concussion), damage to the inner ear balance or hearing sensors (labyrinthine concussion), or from other things like changes in blood pressure, nervous system irregularities, or vision.
What causes post-concussion dizziness?
Labyrinthine concussion: damage may occur in any of the inner ear sensors for balance as well as the balance nerve and/or associated neurological pathways. BPPV may also occur following a concussion. Superior Canal Dehiscence Syndrome (SCDS) can also occur following a head injury. In this condition, there is an abnormal opening in the bone that encases one of the canals in the inner ear. Symptoms include vertigo triggered by loud noise, coughing, sneezing, or straining. Other sounds within the body become over-amplified also like a heartbeat, eyes moving, feet walking on the ground.
Cortical concussion: the brain’s central processing of balance may be affected following a concussion. The brain may have difficulty coordinating information from the eyes, ears, and proprioception. Difficulty with regulation may also occur.
What are the symptoms of post-concussion dizziness?
Symptoms may vary and can include spinning, feeling light-headed, brain fog, poor balance, or a sensation of rocking/swaying. The sound may also trigger dizziness. Quick head turns, quick movements, complex visual environments (scrolling through screens, grocery stores) are often triggers.
How are labyrinthine or cortical concussions diagnosed?
A medical physician with experience in head injuries can diagnose a cortical concussion. An Ear Nose and Throat Specialist (ENT) is the medical professional to diagnose a labyrinthine concussion. Audio-Vestibular testing is important to differentiate peripheral abnormalities (labyrinthine) from central abnormalities.
How is post-concussion dizziness treated?
Regardless of whether the dizziness is peripheral (inner ear) or central (brain), it is important to slow down and not push through symptoms. It is important to take time to slow down when doing things such as getting out of bed or bending, turning quickly. Vestibular Rehabilitation Therapy is a recommended treatment. Staying active is also important as long as care is taken for ‘brain breaks’.
