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Vestibular Consequences of Mild Traumatic Brain Injury (mTBI)

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Traumatic Brain Injury

Abstract

The vestibular organs, encased in the temporal bones of the skull, are vulnerable to blast shock wave and blunt force trauma to the head. Often, more acute injuries elsewhere in the body overshadow the evaluation of vestibular function, which must be considered, examined, and tested for, in the intermediate- and long-term recovery from TBI. Screening procedures include reviewing for symptoms including the presence of vertigo, imbalance out of keeping with other injuries, nausea, and cognitive changes. Activation of migraine syndromes post head injury are common post TBI sequelae, with not only headache but also vertigo, nausea, and imbalance. Oculomotor and vestibular function tests are an important adjunct to careful history taking post TBI. Medical management and physical therapy procedures usually are very effective in mitigating symptoms and returning to normal function.

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References

  1. Helminski JO, Zee DS, Janssen I, Hain TC. Effectiveness of particle repositioning maneuvers in the treatment of benign paroxysmal positional vertigo: a systematic review. Phys Ther. 2010;90(5):663–78.

    Article  Google Scholar 

  2. Hoffer ME, Balaban C, Gottshall K, Balough BJ, Maddox MR, Penta JR. Blast exposure: vestibular consequences and associated characteristics. Otol Neurotol. 2010;31(2):232–6.

    Article  Google Scholar 

  3. McCrory P, Meeuwisse W, Johnston K, Dvorak J, Aubry M, Molloy M, et al. Consensus statement on concussion in sport – the third international conference on concussion in sport held in Zurich, November 2008. Phys Sportsmed. 2009;37(2):141–59.

    Article  Google Scholar 

  4. Hoffer ME, Gottshall KR, Moore R, Balough BJ, Wester D. Characterizing and treating dizziness after mild head trauma. Otol Neurotol. 2004;25(2):135–8.

    Article  Google Scholar 

  5. Hoffer ME, Donaldson C, Gottshall KR, Balaban C, Balough BJ. Blunt and blast head trauma: different entities. Int Tin J. 2009;15(2):115–8.

    Google Scholar 

  6. Hoffer ME, Szczupak M, Kiderman A, Crawford J, Murphy S, Marshall K, et al. Neurosensory symptom complexes after acute mild traumatic brain injury. PLoS One. 2016;11(1):e0146039.

    Article  Google Scholar 

  7. Viirre E, Purcell I, Baloh RW. The Dix-Hallpike test and the canal repositioning maneuver. Laryngoscope. 2005;115(1):184–7.

    Article  Google Scholar 

  8. Vuković V, Plavec D, Galinović I, Lovrencić-Huzjan A, Budisić M, Demarin V. Prevalence of vertigo, dizziness, and migrainous vertigo in patients with migraine. Headache. 2007;47(10):1427–35.

    Article  Google Scholar 

  9. International Headache Society Classification: ICHD-III. https://www.ichd-3.org/.

  10. Balaban C, Hoffer ME, Szczupak M, Snapp H, Crawford J, Murphy S, et al. Oculomotor, vestibular and reaction time tests in mild traumatic brain injury. PLoS One. 2016;11(9):e0162168.

    Article  Google Scholar 

  11. Munoz DP, Everling S. Look away: the anti-saccade task and the voluntary control of eye movement. Nat Rev Neurosci. 2004;5(3):218–28.

    Article  CAS  Google Scholar 

  12. Herman T, Inbar-Borovsky N, Brozgol M, Giladi N, Hausdorff JM. The Dynamic Gait Index in healthy older adults: the role of stair climbing, fear of falling and gender. Gait Posture. 2009;29(2):237–41.

    Article  Google Scholar 

  13. Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Arch Otolaryngol Head Neck Surg. 1990;116(4):424–7.

    Article  CAS  Google Scholar 

  14. Powell LE, Myers AM. The Activities-Specific Balance Confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995;50A(1):M28–34.

    Article  CAS  Google Scholar 

  15. Scherer MR, Schubert MC. Traumatic brain injury and vestibular pathology as a comorbidity after blast exposure. Phys Ther. 2009;89(9):980–92.

    Article  Google Scholar 

  16. Gottshall K, Drake A, Gray N, McDonald E, Hoffer ME. Objective vestibular tests as outcome measures in head injury patients. Laryngoscope. 2003;113(10):1746–50.

    Article  Google Scholar 

  17. Mishra A, Davis S, Speers R, Shepard NT. Head shake computerized dynamic posturography in peripheral vestibular lesions. Am J Audiol. 2009;18(1):53–9.

    Article  Google Scholar 

  18. Nashner LM, Peters JF. Dynamic posturography in the diagnosis and management of dizziness and balance disorders. Neurol Clin. 1990;8(2):331–49.

    Article  CAS  Google Scholar 

  19. Whitney SL, Marchetti GF, Pritcher M, Furman JM. Gaze stabilization and gait performance in vestibular dysfunction. Gait Posture. 2009;29(2):194–8.

    Article  Google Scholar 

  20. Goebel JA, Tungsiripat N, Sinks B, Carmody J. Gaze stabilization test: a new clinical test of unilateral vestibular dysfunction. Otol Neurotol. 2007;28(1):68–73.

    Article  Google Scholar 

  21. Badaracco C, Labini FS, Meli A, Angelis ED, Tufarelli D. Vestibular rehabilitation outcomes in chronic vertiginous patients through computerized dynamic visual acuity and gaze stabilization test. Otol Neurotol. 2007;28(6):809–13.

    Article  Google Scholar 

  22. Pritcher MR, Whitney SL, Marchetti GF, Furman JM. The influence of age and vestibular disorders on gaze stabilization: a pilot study. Otol Neurotol. 2008;29(7):982–8.

    Article  Google Scholar 

  23. Paige GD. Nonlinearity and asymmetry in the human vestibule-ocular reflex. Acta Otolaryngol. 1989;108(1–2):1–8.

    Article  CAS  Google Scholar 

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Correspondence to Erik S. Viirre .

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Szczupak, M., Hoffer, M.E., Gottshall, K., Viirre, E.S. (2020). Vestibular Consequences of Mild Traumatic Brain Injury (mTBI). In: Tsao, J. (eds) Traumatic Brain Injury. Springer, Cham. https://doi.org/10.1007/978-3-030-22436-3_8

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  • DOI: https://doi.org/10.1007/978-3-030-22436-3_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-22435-6

  • Online ISBN: 978-3-030-22436-3

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