Persistent Dizziness After Head Injury: Seeking Answers and Solutions

Abnormal dizziness?

Hello Dr.
Yeh,
Four years ago, I was involved in a car accident that resulted in intracranial hemorrhage.
Although I have been treated with medication to absorb the blood clot, I have been experiencing abnormal dizziness that has persisted until now.
I have consulted with doctors, but the outcome has always been medication to manage the dizziness.
Recently, with the onset of warmer weather, I have been feeling a heavy sensation in my head and experiencing intermittent dizziness starting around noon for over a week.
I work in an office, and I am unsure if this could be a residual effect of the accident.
I would like to know if I need to undergo tests such as an EEG.
This dizziness has also affected my appetite, and I have been feeling nauseous.
Is it possible that my condition may not improve?

TINA, 20~29 year old female. Ask Date: 2001/06/11

Dr. Ye Boshou reply Neurology

The causes of T0-TINA dizziness are numerous and often related to mood and environment, not necessarily linked to intracranial bleeding from a car accident.
The treatment approach must first identify the underlying cause in order to provide appropriate care.
This is the response from Dr.
Yeh Po-Shou, Director of the Neurology Department.

Reply Date: 2001/06/11

More Info

Persistent dizziness after a head injury, especially one that involved intracranial bleeding, can be a complex issue that requires careful evaluation and management. Given your history of a car accident four years ago that resulted in intracranial bleeding, it is understandable that you are experiencing ongoing symptoms such as dizziness, a heavy feeling in your head, and gastrointestinal discomfort like nausea and loss of appetite.

First and foremost, it is important to recognize that post-concussion syndrome can occur after a head injury, even if the initial injury was years ago. Symptoms can include dizziness, headaches, cognitive difficulties, and emotional changes. The fact that your dizziness worsens with heat and is accompanied by nausea suggests that your body may be reacting to environmental stressors, which can exacerbate vestibular (balance-related) issues.

In terms of diagnostic steps, it would be prudent to consult with a neurologist or a specialist in vestibular disorders. They may recommend imaging studies such as an MRI or CT scan to rule out any structural issues that could be contributing to your symptoms. Additionally, an electroencephalogram (EEG) could be considered if there is a suspicion of seizure activity, although this is less common in cases of dizziness alone.

Physical therapy, particularly vestibular rehabilitation therapy (VRT), can be highly beneficial for individuals experiencing dizziness after a head injury. This type of therapy focuses on exercises that help improve balance and reduce dizziness. A trained physical therapist can tailor a program specific to your needs, which may help alleviate some of your symptoms.

Moreover, managing your symptoms with medication may also be necessary. While you mentioned that medications have been prescribed to control your dizziness, it is essential to have a thorough discussion with your healthcare provider about the effectiveness of these medications and any potential side effects. Sometimes, adjusting the dosage or trying different medications can lead to better symptom management.

Lifestyle modifications can also play a significant role in managing dizziness. Staying hydrated, avoiding sudden movements, and incorporating regular, gentle exercise can help improve your overall well-being. Additionally, stress management techniques such as mindfulness, yoga, or meditation can be beneficial, as stress can often exacerbate dizziness and other symptoms.

Regarding your concerns about whether your condition is permanent, it is difficult to predict the long-term outcome without a comprehensive evaluation. Many individuals experience improvement over time, but some may continue to have lingering symptoms. The key is to remain proactive in seeking treatment and to communicate openly with your healthcare providers about your symptoms and any changes you experience.

In summary, persistent dizziness after a head injury can be a challenging condition to manage. It is crucial to seek specialized care, consider vestibular rehabilitation, and explore medication options while making lifestyle adjustments. With the right approach, many individuals find relief from their symptoms and can improve their quality of life.

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