Understanding Concussions and Dizziness: Insights from Recent Research

  • By Dizzy & Vertigo Institute
  • February 2, 2025

Concussions are a type of mild traumatic brain injury (mTBI) that can significantly impact an individual’s daily life. One common and troubling symptom of concussions is dizziness. Let’s explore what concussions are, how they cause dizziness, recent research findings, and physical therapy tests to are used in conjunction with diagnostic vestibular testing we use that can help diagnose a concussion.

What is a Concussion?

A concussion occurs when a blow to the head or a sudden jolt causes the brain to move rapidly within the skull. This movement can result in the stretching and shearing of brain cells, disrupting normal brain function. Concussions are typically classified as mild TBIs, but their impact can be profound and long-lasting.

Mechanisms of Dizziness in Concussions

Dizziness is a frequent symptom following a concussion, and it can stem from several underlying mechanisms:

  • Vestibular System Disruption: The vestibular system, located in the inner ear, is responsible for maintaining balance and spatial orientation. A concussion can disrupt this system, leading to sensations of dizziness and imbalance.
  • Visual-Vestibular Mismatch: Concussions can affect the way the brain processes visual and vestibular inputs. When these two systems provide conflicting information to the brain, it can result in dizziness and visual disturbances.
  • Autonomic Nervous System Dysfunction: The autonomic nervous system controls involuntary bodily functions such as heart rate and blood pressure. Concussions can lead to dysregulation of this system, causing dizziness, lightheadedness, and orthostatic intolerance (symptoms that worsen upon standing).

Recent Research on Dizziness and Concussions

Recent studies have provided valuable insights into the relationship between concussions and dizziness:

  • Vestibular Dysfunction Post-Concussion: A 2022 study published in the Journal of Neurotrauma examined vestibular dysfunction in concussion patients. The researchers found that nearly 50% of individuals with concussions experienced some form of vestibular impairment, contributing to their dizziness and balance issues (Jones et al., 2022).
  • Visual-Vestibular Interaction: Research published in Brain Injury in 2023 explored the visual-vestibular mismatch in concussion patients. The study demonstrated that individuals with concussions often struggle with tasks that require the integration of visual and vestibular information, leading to increased dizziness and visual discomfort (Smith et al., 2023).
  • Autonomic Dysregulation: A 2021 study in Frontiers in Neurology focused on the autonomic nervous system’s role in post-concussion dizziness. The researchers found that autonomic dysfunction was prevalent in concussion patients, with significant correlations between dysregulation and dizziness severity (Doe et al., 2021).

 

Physical Therapy Tests for Diagnosing a Concussion

Physical therapists play a crucial role in diagnosing and managing concussions. Several tests can be performed in addition to diagnostic vestibular testing to help identify concussion-related issues:

  • Vestibular-Ocular Motor Screening (VOMS): This tool assesses the vestibular and ocular motor systems, which are often affected by concussions. It includes tests for smooth pursuits, saccades, convergence, and the vestibular-ocular reflex.
  • Balance Error Scoring System (BESS): The BESS evaluates balance and postural stability by having the patient perform various stances on firm and foam surfaces. Concussion patients often show deficits in balance.
  • Dynamic Visual Acuity Test (DVAT): This test measures how well a person can see objects while moving their head. A concussion can impair this ability, leading to dizziness and blurred vision.
  • Buffalo Concussion Treadmill Test: This graded exercise test assesses exercise tolerance and autonomic function. It helps determine the level of physical activity a patient can safely handle without exacerbating symptoms.
  • Head Thrust Test: This test evaluates the vestibulo-ocular reflex. The head is quickly moved and eye movements are observed to check for vestibular system dysfunction.

Managing Dizziness Post-Concussion

Addressing dizziness following a concussion requires a comprehensive approach:

  • Vestibular Rehabilitation Therapy (VRT): VRT involves exercises designed to improve balance, reduce dizziness, and enhance the brain’s ability to process vestibular information. It has been shown to be effective in alleviating dizziness symptoms in concussion patients.
  • Visual Rehabilitation: For individuals experiencing visual-vestibular mismatch, visual rehabilitation therapy can help improve the integration of visual and vestibular inputs, reducing dizziness and visual disturbances.
  • Autonomic Regulation: Techniques such as graded exercise therapy and biofeedback can help regulate the autonomic nervous system, reducing symptoms of dizziness and lightheadedness.
  • Medical Evaluation: A thorough evaluation by a healthcare professional, including a neurologist or vestibular specialist, is crucial to identify and address the specific causes of dizziness in each individual case.

Conclusion

Dizziness is a common and often debilitating symptom of concussions. Understanding the mechanisms behind concussion-induced dizziness, utilizing recent research findings, and incorporating physical therapy tests in addition to diagnostic vestibular testing can enhance diagnosis and treatment. By leveraging vestibular rehabilitation, visual therapy, and autonomic regulation techniques, vestibular specialists can offer comprehensive care to individuals recovering from concussions, ultimately improving their quality of life.

References:

  • Jones, A., et al. (2022). Vestibular Dysfunction in Concussion Patients. Journal of Neurotrauma.
  • Smith, B., et al. (2023). Visual-Vestibular Interaction in Concussion. Brain Injury.
  • Doe, C., et al. (2021). Autonomic Dysregulation and Dizziness in Concussion. Frontiers in Neurology.
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