Traumatic Brain Injury and Balance Disorders

Common causes of balance problems following a TBI may include:

• Neurological injury: Damage to the cerebellum, brainstem, or neural pathways that process balance information can affect coordination and posture.
• Inner-ear injury: Head trauma may damage the vestibular system, which detects head position and movement.
• Displaced inner-ear crystals: Trauma can trigger benign paroxysmal positional vertigo, or BPPV, causing brief spinning sensations when rolling over, looking upward, or getting out of bed.
• Vision problems: Blurred vision, double vision, or difficulty coordinating eye movements can make the surroundings appear unstable.
• Sensory or motor impairment: Weakness, delayed reactions, or reduced awareness of limb position can make standing and walking more difficult.
• Other contributing factors: Migraine, medication side effects, fatigue, and concentration problems may aggravate balance symptoms following a head injury.

Symptoms may include spinning, swaying, veering while walking, unsteadiness, or difficulty maintaining balance in darkness or visually crowded environments.

Evaluation and treatment may include vestibular testing, vestibular compensation and rehabilitation (VCR), vision therapy, medication review, or repositioning maneuvers for BPPV.