Post-traumatic vertigo is a sensation of spinning that occurs after a head or neck injury. Let’s talk about what vertigo is and then see how it is caused by an injury.
To be specific, vertigo is the false feeling of movement. You will most likely feel like the room around you is spinning or you may feel like you are spinning. However, there is actually no movement. If you are experiencing vertigo you may have the following symptoms:
- Feeling off balance
- Feeling like you are pulled in one direction
- Nausea and vomiting
- Abnormal eye movements called nystagmus
- Hearing loss
- Tinnitus — ringing in the ears
Symptoms can last anywhere from a few minutes to a few hours or even longer. They may come and go.
Common Causes of Vertigo
In many cases, vertigo is related to an inner ear issue. Some of the causes for this can be:
- Meniere’s disease: This is an inner ear disorder thought to possibly be due to a buildup of fluid that changes the pressures in the ear. It can lead to episodes of vertigo, tinnitus (ringing in the ear), and fluctuating hearing loss.
- Vestibular neuritis or labyrinthitis: Usually due to an infection or virus, the inner ear around the nerves gets inflamed. This affects the body’s sense of balance.
- Benign paroxysmal positional vertigo (BPPV): Tiny calcium particles, called canaliths, move out of their original position and settle in the canals of the inner ear. The inner ear is responsible for sending signals to the brain about the movement of the body in relation to gravity. This is how you keep your balance. BPPV can happen with no underlying cause and may be age-related.
Less common reasons for vertigo:
- Certain medications that cause ear damage
- Brain problems: stroke or tumor
- Head or neck injuries
Notice the last thing mentioned here is head and neck injury. This leads us to our discussion about post-traumatic vertigo.
Yearly, head injuries are incurred by 5% of the population. If you have post-traumatic vertigo, you have vertigo after having a head or neck injury. Most often, injuries to other areas of the body do not lead to vertigo. Healthcare providers are very cautious when it comes to making this type of diagnosis, however.
The Cause of Post-Traumatic Vertigo
There are many causes of this kind of vertigo. Some we have mentioned above. We will take a closer look at these and how they relate to post-traumatic vertigo.
- BPPV: This only happens when the head is moved in certain positions. It is possible that the blow to the head caused the tiny particles to break loose and move out of place. This results in balance issues. There are a number of therapies that can be tried to reposition the particles.
- Brainstem disturbances
- Vestibular atelectasis
- Utricular injuries
- Meniere’s disease: A blow to the head can cause the drainage pathways of the ears to scar, leading to the fluid not draining properly.
- Labyrinthine concussion: This is a non-persistent hearing or labyrinthine disturbance specifically after a head injury. Hearing loss or nystagmus must be present to make this diagnosis with certainty.
- A post-traumatic migraine: This is a migraine accompanied by vertigo, a common combination after head injuries.
- Cervical vertigo: Severe imbalance that follows a neck injury.
- Temporal bone fracture: Severe vertigo follows an injury that caused a skull fracture, sometimes accompanied by hearing loss or peripheral facial weakness (Bell’s palsy).
- Perilymph fistula: This occurs after straining or blowing the nose.
- Factitious vertigo: Complaints of vertigo are related to psychological causes such as anxiety and depression.
- Epileptic vertigo: This is connected to a brain injury, especially involving the temporal lobe that processes vestibular signals. It can include loss of consciousness at the time of the injury.
- Diffuse axonal injury (DAI)
- Post-concussion syndrome: This is a combination of a headache, dizziness, and a mental disturbance following a head injury.
What Can Be Done for Post-Traumatic Vertigo?
Before finding a solution, we must know why head and neck injuries cause vertigo. The spine has the major responsibility of protecting the delicate spinal cord. The C1 and C2 vertebrae are designed to protect the brainstem. The brainstem and spinal cord are the communication highway between the brain and the body. This helps the brain know exactly where the body is located in its environment. If either the C1 or C2 moves out of place due to a head or neck injury, it can begin to exert stress on the brainstem. This causes the brainstem to malfunction and begin sending improper signals to the brain about where the body is located. The brain is also receiving signals from other receptors in the body. If these signals don’t match up, vertigo is the end result.
A study was conducted by Dr. Erin Elster, an upper cervical chiropractor, observing 60 patients who had been diagnosed with vertigo. Out of the 60, all but 4 could remember having some sort of accident affecting their head or neck before the onset of vertigo. These patients all received an upper cervical adjustment to correct the misalignment in their neck. As many as 48 saw their vertigo go away completely. The rest reported a huge improvement in their symptoms.
Here at Corsello Clinic of Chiropractic in Stratford, Connecticut, we use a similar technique and see similar results. The method we use is gentle and does not rely on forcing the bones into place. Rather, we encourage them to move back into place naturally, helping them to stay in place longer and not put more stress on the neck. Many patients report seeing an improvement in or an end to their vertigo in a short amount of time.