Incidence and Treatment Outcomes of Post Traumatic BPPV in Traumatic Brain Injury Patients

Abstract

The aim of this study is to assess the incidence of post traumatic BPPV and evaluate its treatment outcomes in mild and moderate traumatic head injury patients. The study population consisted of 128 patients (89 male:39 female) who were admitted with head and neck injury (Motor Vehicle Accident, Blow to the head, Fall from Height, Whiplash injury) as inpatients in Department of Neurosurgery in Tertiary care hospital in Kerala during a 2 month period from 1st April 2014 to 31st May 2014. The age range was 10-70 years and mean 39.8 with standard deviation 15.5. All cases were evaluated and serially followed up to a period of 6 months in Department of Otorhinolaryngology. In our study, the number of patients with mild injuries (Glasgow coma scale 13-15) were 108 and moderate injury (Glasgow coma scale 9-12) were 20. We found out that post traumatic BPPV was found to be 17% of the traumatic brain injury patients. All patients were treated with particle re-positioning maneuvers and were followed up for a period of 6 months. Recurrence were reported in 9 (40.9%) patients. In these patients re positioning maneuvers were repeated.

Incidence of Benign Paroxysmal Positional Vertigo in Head Injury Patients

“…This is in accordance with Ahn et al and Davies et al who have reported an incidence of 23% and 25% respectively [5]However, others have documented a lower incidence varying from 8.5% to 17% [7,10,12,13]. The commonest age group affected was 31-50 years group(44.4%) which is in agreement with Jozefowicz Korczynska et al and Haripriya et al [14,13].Males predominated in our cohort(55.6%). Similar observations have been made by others [14,13].…”

“…The commonest age group affected was 31-50 years group(44.4%) which is in agreement with Jozefowicz Korczynska et al and Haripriya et al [14,13].Males predominated in our cohort(55.6%). Similar observations have been made by others [14,13].…”

“…Head injury due to two wheeler accidents was the common cause of head injury in 5 of the 9 patients with BPPV (55.6%) followed by falls in 2 patients(22%), which is in agreement with the study by Haripriya et al [14]. Nearly three fourth patients with BPPV had mild head trauma.…”

“…Similar views have been echoed by others. [14,13]. The posterior semicircular canal, being the most dependent part when the patient is in supine position, the dislodged otoconia becomes trapped and hence is commonly involved in BPPV.…”

“…was abnormal in 5 (55.6%)patients, fracture in the temporal bone in 2, intracranial hemorrhage in 2, and contusion in one. Ouchterlony et al [14] have quoted a higher percentage of 76.2%, whereas Haripriya et al [14]have recorded a lower incidence of 36.4%. The intracranial pathology following head trauma depend on the mechanism, severity and extent of head injury and hence probably the variation in the incidence of abnormal imaging findings in various studies.…”