Otoneurogical study on vertigo after head trauma : a concept of delayed brainstem concussion syndrome

Eighty-three patients with post-traumatic vertigo of acute onset and eighteen with that of delayed onset were studied among cases which were examined otoneurogically at Department of Otorhinolary ngology of Yamaguchi University Hospital in the past 10 years. As the origin of post-traumatic vertigo of the acute onset, central involvement was about twice as frequent as peripheral vestibular involvement, and in the delayed onset group of post-traumatic vertigo the former was about three times as frequent as the latter. In the acute onset group, the peripheral vestibular involvement was well compensated within one year after the trauma, and the frequency of positive findings decreased significantly. There was no significant relationship between the duration of consciousness disturbance at the time of injury and otoneurogical findings in the acute onset group. But, in the delayed onset group, all the patients who were accompanied by consciousness disturbance at the time of trauma showed findings suggesting central invelvement. We propose that such vertigo of delayed onset which manifests central involvement, especially in the brainstem and/or cerebellum, should be called ''delayed brainstem concussion syndorome''.