Balance Deficits and Dizziness after Brain Injury
Steve Gerdes • April 29, 2025
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About 78% of persons who suffer brain injury or concussion develop problems with dizziness and balance. ENT doctors with a sub-specialty in neuro-otology are ideally suited to treat these conditions because of their additional training in treating vestibular (balance) conditions. Neuro-otologists work closely with specially training physical therapists to provide therapy designed to improve balance. After treatment, most patients with brain injury find that their balance has significantly improved
A concussion is a mild traumatic brain injury. It is the physiological disruption of brain function caused by trauma that is manifested by at least one of the following: Any period of loss of consciousness; Any loss of memory for events immediately before or after the accident; Any alteration in mental state at the time of accident (e.g. feeling dazed, disoriented, or confused) Focal neurological deficit(s) that may or may not be transient. A person does not have to hit his or her head or be hit by an object. The movement of the brain inside the skull, such as in a whiplash injury, may be sufficient to cause damage.
Some people who suffer a concussion become easily tired and fatigued. This can happen for a variety of reasons. The brain powers itself off of the body's glucose. When the brain has been injured it may need more energy to repair itself or to process confusing sensory information it receives from the eyes and other parts of the body. Another factor can be problems with sleep whether caused by pain or by central sleep apnea. In yet other cases, some brain damage occurred in the brain stem area, which includes the areas responsible for regulating the autonomic nervous system. When doctors become aware of a patient with complaints of fatigue, they can order special tests such as Autonomic Nervous System testing and the Buffalo Concussion Treadmill test to diagnose the condition. Correct diagnoses help doctors know the best therapy to help patients get better.
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Standard MRI scans are rarely able to show brain damage even when damage is present. High powered 3-Telsa MRI scanners often have the ability to show damage in a person who has suffered a concussion or mild brain injury. MRI protocols such as Diffusion Tension Imaging (DTI), Flair, Susceptibility Weighted Imaging (SWI) and Gradient Echo Series may be used to reveal the damage. Many 3-Telsa scanners are used primarily for research. Doctors can refer patients to VitalView Imaging in Omaha for clinical 3-Tesla brain MRI scans.