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Lightheadedness After Concussion: Not All Dizziness is Vertigo.

Geoffrey L Heyer1,2, Julie A Young3, Anastasia N Fischer3,2

  • 1Division of Pediatric Neurology, Nationwide Children's Hospital, Columbus, Ohio.

Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine
|July 15, 2017
PubMed
Summary

Postconcussion lightheadedness is common and distinct from vertigo. Its presence during clinic evaluation may predict a longer concussion recovery period, highlighting the need for careful symptom assessment.

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Area of Science:

  • Neurology
  • Sports Medicine
  • Autonomic Dysfunction

Background:

  • Concussion, a traumatic brain injury, can lead to various symptoms, including dizziness and lightheadedness.
  • Differentiating between postconcussion lightheadedness and vertigo is crucial for accurate diagnosis and treatment.
  • Previous research suggests a link between concussion and autonomic nervous system dysfunction.

Purpose of the Study:

  • To characterize the prevalence and severity of postconcussion lightheadedness compared to vertigo and dizziness.
  • To determine if lightheadedness impacts the overall duration of concussion symptoms.
  • To explore the relationship between lightheadedness and other postconcussion symptoms.

Main Methods:

  • Prospective cohort study involving 510 patients aged 9-19 years within 30 days of concussion.
  • Patients rated multiple postconcussion symptoms, including lightheadedness, vertigo, and dizziness, on a 0-6 scale.
  • Statistical analysis, including principal component analysis, was used to identify symptom correlations and predictors of prolonged recovery.

Main Results:

  • Postconcussion lightheadedness was more frequently reported than vertigo, both on the day of concussion and at clinic evaluation.
  • Lightheadedness, vertigo, balance issues, concentration difficulties, and memory problems were strongly correlated.
  • Presence of these correlated symptoms at clinic evaluation predicted prolonged concussion recovery (HR=1.2).

Conclusions:

  • Postconcussion lightheadedness is a common symptom, distinct from vertigo.
  • Lightheadedness, when present during clinic evaluation, can be an indicator of prolonged concussion recovery.
  • Findings support an association between concussion and autonomic dysfunction, emphasizing the importance of distinguishing lightheadedness from vertigo in clinical practice and research.