Neurootological aspects of posttraumatic complaints after severe head trauma
Abstract
Concussion of the brain describes a violent jar or shock, or the condition which results from such an injury. Loss of consciousness obviously appears as the result of a blow to the head.
In mild concussion there is transient loss of consciousness with possible impairment of the higher mental functions, such as retrograde amnesia and emotional lability.
In severe concussion there is prolonged unconsciousness with impairment of the functions of the brain stem, such as transient loss of respiratory reflex, vasomotor activity, and dilatation of the pupils. Concussion is sometimes differentiated from contusion in that in the former the injury is functional, whereas in the latter it is organic. Contusion is due to a bruise, an injury of a part without a break in the skin. Posttraumatic cerebral syndrome occurs in the recovery phase and for months thereafter. In relation there maybe complaints of headache, vertigo, tinnitus, hearing loss, giddiness, easy fatigability, memory defects, impaired ability to concentrate, dizziness and personality changes. It is more common after serious head injuries. But severe symptoms maybe produced by relatively minor injuries as well.
For this study 102 cases with posttraumatic complaints due to an earlier head trauma were investigated (79,41% males, 20,59% females). When analysing the history on the basis of NODEC the 6 major vertigo symptoms statistically were found with a frequency of 1,58 signs per patient and the total of 11 vertigo and nausea symptoms with a frequency of 2,05 signs per patient. Tinnitus were reported in 43,14% and hearing loss in 50,98%.
By means of objective and quantitative neurootometry the following rates of functional neurosensorial disturbances were observed: butterfly calorigram of the polygraphic ENG 75,49%, stepping-CCGs 76,47%, pure tone audiometry of bone conduction in the right 40,20% and in the left ear 49,02%.