Traumatic brain injuries, due to vestibular deficits, not only cause initial damage to the Central Nervous System, but increase the risk of additional neurologic problems and dramatically impact the ongoing costs associated with caring for the patient, says Alabama traumatic brain injury attorney Keith T. Belt.
At least one concussion symptom was common in roughly two-thirds of pediatric sports medicine and orthopedic patients who had no history of the disorder. However, vestibular deficits — common in roughly 81% of a separate sample of pediatric sports medicine clinic patients who did have concussions — were not seen in this healthy group, according to research from Neil Khanna, BS, of the Feinberg School of Medicine in Chicago, Ill., and colleagues.
The large presence of vestibular deficits was associated with extended recovery time and need for vestibular rehabilitation in those whose symptoms persisted 4 weeks after injury, according to Daniel Corwin, MD, of the Children’s Hospital of Philadelphia in Pennsylvania, and colleagues who presented the findings during a poster session at the meeting of the American Academy of Pediatrics.
The AAP released a recommendation at the meeting that concussed students should take time off from the classroom as well as from the field following their injury, and that recovery should incorporate a team-based approach.
And although the effects of concussions can be felt even after standard symptoms are resolved, symptoms of concussion in kids ages 10 to 17 are common in 67.2% of boys and 55.9% of girls. Roughly a quarter of participants reported nervousness (27.4%), trouble falling asleep (23.2%), difficulty concentrating (22.1%), and difficulty remembering (22.1%), as well as sleeping more than usual in 16.8%, headache in 15.8%, and irritability in 14.7%.
These symptoms were significantly more severe in participants who were multi-sport versus single-sport athletes, but there was no correlation between age or sex with symptom frequency or severity.
Causes – Persisting vestibular deficits after moderate and severe TBI are due to peripheral and central nervous system lesions and associated injuries, such as fractures, which can cause:
- Muscle weakness and paralysis, which result in an inability to prevent movement and/or an inability to quickly initiate postural responses necessary to maintain balance.
- Biomechanical constraints, such as limited ROM and weight-bearing activities, necessary to maintain postural balance and for compensation by the intact components.
- Poor motor coordination of the trunk and leg muscles into movement strategies with postural control
- Dysfunction in the vestibular, visual, or somatosensory systems, or in the central integration of the 3 systems
Symptoms and Prognostic Indicators
- Positional vertigo, the sense of the room spinning around the patient, is the most common persisting vestibular symptom following TBI.
- Oscillopsia, the illusion that stationary objects are moving back and forth, and severe nausea and vomiting, usually indicate a vestibular system disorder as well.
- Low initial Glasgow Coma Scale scores and deep parenchymal brain lesions demonstrated by MRI are significant indicators of subsequent severe postural imbalance.
Symptoms common to patients with vestibular deficits included abnormal tandem gait (76.1%), fast saccades (44.5%), problems with gaze stability (34.4%), positive Romberg sign (6.4%), and dysmetria (4.4%).
More than half of the patients were referred for vestibular therapy (53%) were clear to play sports after a median 102 days and clear for return to school in 7 days. Concussed patients without vestibular deficits returned to play after a median 32 days. Among those with prior concussions, 90% had vestibular deficits and 57% were referred for vestibular therapy.
They concluded that concussed pediatric patients, particularly those with prior concussions, were at high likelihood to develop vestibular deficits. These deficits were not common to sports medicine patients without concussion but who reported concussion symptoms. However, in the near future those woozy players may be able to use an inhaler to ingest a drug that protects against further brain damage, helping mitigate a harmful biochemical cascade in the brain that follows the initial blow.
This could be a reality in the not too distant future due to ongoing research at the University of Alabama at Birmingham funded as part of a $1.5 million grant package to institutions for sport-related medical research by NFL Charities, the charitable foundation of the National Football League owners.
Talk to the Alabama Traumatic Brain Injury Lawyers at Belt, Bruner, & Barnett P.C. Today
With offices in Birmingham, Mobile, Huntsville, and Montgomery, our motorcycle accident lawyers will travel to the location most convenient to you. If you or a loved one has been hurt in a serious accident in Birmingham, Mobile, Huntsville, and Montgomery and sustained a traumatic brain injury, call an experienced Alabama injury lawyer at Belt, Bruner, & Barnett P.C. today at (205) 933-1500.
