Persistent Dizziness After Head Injury: A Neurological Perspective

Q: Persistent Dizziness After Head Injury: A Neurological Perspective

Hello： Essentially, the aftereffects of a concussion often include dizziness, but since it has been two years and you are still experiencing prolonged dizziness, this is quite uncommon. <br>It is advisable to consult an otolaryngologist, as it may be related to an inner ear balan

Car accident, boating?

Two years ago, I was involved in a car accident where my head directly struck the asphalt road.
I was taken to the hospital by ambulance.
At that time, X-rays and MRIs indicated that there was nothing wrong, and there were no obvious external injuries, so I went home to rest shortly after.
However, I began to frequently experience dizziness, headaches, and a sensation of the world spinning around me, which worsened when there were vibrations or movements nearby.
I have returned for follow-up visits several times, and each time I was told that everything was fine, and I was prescribed anti-nausea medication.
While taking the medication, my symptoms would subside, but shortly after finishing the medication, the symptoms would reappear (this has been a recurring issue for the past two years).
I would like to know why this is happening if there is nothing wrong.
Recently, I need to go out to sea for work for 20 consecutive days.
Is it still possible for me to go? (Because previously, when I went to Xiao Liuqiu, I couldn't handle it even with motion sickness medication...)

Niming, 20~29 year old female. Ask Date: 2015/12/23

Dr. Zhang Junwei reply Neurosurgery

Hello: Essentially, the aftereffects of a concussion often include dizziness, but since it has been two years and you are still experiencing prolonged dizziness, this is quite uncommon.
It is advisable to consult an otolaryngologist, as it may be related to an inner ear balance issue.
Given the severity of your dizziness, going out to sea would certainly not be appropriate.

Reply Date: 2015/12/23

More Info

Understanding persistent dizziness after a head injury can be quite complex, especially when the initial medical evaluations, such as X-rays and MRIs, show no significant abnormalities. Your experience following the car accident, where you sustained a direct impact to the head, is not uncommon. Many individuals report ongoing symptoms like dizziness and headaches long after the initial injury, even when no structural damage is evident.

The symptoms you describe—persistent dizziness, headaches, and exacerbation of symptoms with movement or vibration—could be indicative of several underlying issues. One possibility is post-concussion syndrome (PCS), which can occur after a mild traumatic brain injury (TBI), such as a concussion. PCS is characterized by a variety of symptoms, including headaches, dizziness, cognitive difficulties, and emotional changes, which can persist for weeks, months, or even years after the injury.

Another potential explanation for your symptoms could be vestibular dysfunction. The vestibular system, which is responsible for balance and spatial orientation, can be affected by head injuries. This dysfunction can lead to feelings of dizziness, imbalance, and vertigo, especially in situations where there is movement or vibration, such as being on a boat or in a moving vehicle.

It's also important to consider the possibility of psychological factors. Chronic pain and persistent dizziness can lead to anxiety and stress, which may exacerbate your symptoms. The mind-body connection is powerful, and psychological distress can manifest as physical symptoms.

Regarding your upcoming work commitment that involves being at sea for 20 days, it is crucial to evaluate your current health status. If you have a history of motion sickness and have experienced significant dizziness in the past, it may be wise to consult with a healthcare professional before making any decisions. They can provide a thorough assessment and may suggest a tailored treatment plan, which could include vestibular rehabilitation therapy, cognitive behavioral therapy, or adjustments to your medication regimen.

In terms of management, if you find that the dizziness and headaches are significantly impacting your daily life, it may be beneficial to seek a referral to a neurologist or a specialist in vestibular disorders. They can conduct more specialized tests to assess your balance and dizziness and help determine the best course of action.

In summary, while your initial evaluations may have shown no significant findings, persistent symptoms following a head injury warrant further investigation. It is essential to communicate openly with your healthcare providers about the ongoing nature of your symptoms and their impact on your quality of life. With appropriate management and support, many individuals can find relief and improve their functioning after experiencing persistent dizziness following a head injury.

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