Posttraumatic vertigo

Abstract

✓ Posttraumatic vertigo may be an accompanying symptom associated with concussion and with the post-concussion state. It is possible, however, that these symptoms are related to perilymphatic fistulas and are not the direct result of cerebral concussion. Although many fistulae heal spontaneously, patients with persistent vertigo and fluctuating hearing loss following head trauma may have associated defects in the perilymphatic channels with fistulas in the region of the oval or round windows. This paper presents results of surgical repair in three patients with fistulas. Surgical intervention becomes much more urgent when sensory neural hearing loss has occurred acutely or has developed during the course of illness.

Benign paroxysmal positional vertigo resulting from surgical trauma

“…Rare causes of BPPV include spontaneous degeneration of the utricle, and occlusion of the anterior vestibular artery. Some cases of post-traumatic BPPV have been shown to result from a perilymphatic fistula (Jacobs et al, 1979), but in the majority the exact pathological derangement is not known. The presence of basophilic calcium concretions in the ampulla of the posterior semicircular canal found at autopsy in paients with BPPV has led to the opinion that the condition results from a rupture of the utricular otolithic membrane and consequent release of otoconia into the endolymph of the pars superior.…”