Results of otovestibular tests in mild head injuries

The neurootological workup of patients with minor head trauma was carried out prospectively. The preliminary results of the ongoing study were derived from 38 subjects (12 female, 26 male) at an average age of 33.5 years. All had been hospitalized after having suffered minimum head trauma followed by a temporary loss of consciousness, by amnesia, or by vomiting. The 38 subjects underwent the examination within 72 hours of the event and were summoned for a follow-up visit 3 months later. The anamnestic data show that the most frequent complaint was dizziness (81%). Tinnitus was noted in fewer than one-half of the patients, with a variety of descriptions. Twenty-six percent complained of hearing loss. The correlation between reported hearing loss and the finding on subsequent behavioral audiometry (within 72 hours after the event) was studied. The sensitivity of hearing loss (as complaint) was found to be only 40%, but its specificity was much higher at 83%. The overall equilibrium reflected in the composite score of the sensory testing in computed dynamic posturography actually worsened between tests. A good correlation was found between posturography results and symptomatology. We concluded that, after minor head trauma, most patients suffer from dizziness, and more than one-half complain of tinnitus or hearing loss. The unsteadiness does not subside within 3 months after concussion. A more protracted follow-up is required to summarize the outcome of head injury from a neurootological point of view. A clear correlation is found between complaints and posturography results. After minor head trauma, pure vestibular injuries are much less frequent than are central lesions. Motor dysfunction is less frequent than are the sensory abnormalities.