Post-Concussion Symptoms: Tinnitus and Dizziness Explained

Post-concussion syndrome

In mid-November, I was hit by a motorcycle that ran a red light while crossing the street.
I lost consciousness at the time, but I'm not sure how long it lasted.
My brain may have suffered a concussion due to the impact with the ground.
I underwent a CT scan of my brain, and the doctor informed me that there was intracranial bleeding.
The blood clot is not large enough to require surgery and is expected to be naturally absorbed over approximately one and a half months.
After resting at home for about a week, I began to experience tinnitus, which occurs throughout the day and varies in intensity.
I also consulted an otolaryngologist, who performed a hearing test.
The doctor prescribed allergy medication, vitamin B complex, and ginkgo biloba, but mentioned that these are only adjunctive treatments.
If my condition does not improve with these medications, I can stop taking them.
My hearing will be monitored continuously.

I would like to ask if the tinnitus is caused by the brain injury.
Is it possible that the blood clot is pressing on a nerve and causing this? Will the tinnitus only resolve once the blood clot disappears? Currently, although my dizziness has improved, I still occasionally feel a spinning sensation when lying down, and I experience dizziness when standing up, looking up or down, or making sudden movements.
Are these symptoms also expected to resolve only after the blood clot disappears?

Miss Zhang, 40~49 year old female. Ask Date: 2016/12/12

Dr. Zhang Junwei reply Neurosurgery

It is possible, but it could also be caused by inner ear imbalance.

Reply Date: 2016/12/12

More Info

After experiencing a concussion and subsequent intracranial hemorrhage, it's understandable to have concerns about the symptoms you're facing, such as tinnitus (ringing in the ears) and dizziness. These symptoms can indeed be related to the traumatic brain injury you sustained.

Tinnitus can occur for various reasons, including exposure to loud noises, ear infections, or head injuries. In your case, the tinnitus may be linked to the concussion and the associated changes in your brain and auditory pathways. The trauma from the impact could have affected the auditory nerve or the areas of the brain responsible for processing sound, leading to the perception of ringing or buzzing in the ears. Additionally, the presence of a blood clot in the brain could potentially exert pressure on surrounding structures, which might contribute to both tinnitus and dizziness.

Dizziness, particularly the sensation of spinning (vertigo), can also be a common aftermath of a concussion. This can occur due to disturbances in the vestibular system, which is responsible for balance and spatial orientation. The concussion may have disrupted the normal functioning of this system, leading to episodes of dizziness when you change positions or move your head. The fact that you experience dizziness when lying down, getting up, or making sudden movements suggests that your vestibular system may still be recovering from the injury.

Regarding your question about whether these symptoms will resolve once the blood clot disappears, it's possible but not guaranteed. While the resolution of the clot may alleviate some pressure and allow for improved function, recovery from concussion-related symptoms can be variable. Some individuals may experience lingering symptoms for weeks or even months after the initial injury, regardless of the status of any intracranial bleeding.

It's crucial to continue monitoring your symptoms and maintain regular follow-ups with your healthcare providers. They may recommend further evaluations, such as vestibular rehabilitation therapy, which can help address balance issues and dizziness. Additionally, if your tinnitus persists or worsens, further assessments by an audiologist or an ear, nose, and throat (ENT) specialist may be warranted to explore other potential underlying causes or treatment options.

In summary, both tinnitus and dizziness can be related to your concussion and the subsequent intracranial hemorrhage. While the resolution of the blood clot may help improve your symptoms, it's essential to remain vigilant and seek ongoing medical advice to manage your recovery effectively. Engaging in a supportive care plan, including rest, gradual return to normal activities, and possibly vestibular therapy, can aid in your recovery process.

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