Akin Faith W, Murnane Owen D, Hall Courtney D, Riska Kristal M
a Vestibular Laboratory, James H. Quillen VA Medical Center , Mountain Home , Tennessee , USA.
b Department of Audiology and Speech Language Pathology , East Tennessee State University , Johnson City , Tennessee , USA.
Brain Inj. 2017;31(9):1188-1194. doi: 10.1080/02699052.2017.1288928.
The purpose of this article is to review relevant literature on the effect of mild traumatic brain injury (mTBI) and blast injury on the vestibular system. Dizziness and imbalance are common sequelae associated with mTBI, and in some individuals, these symptoms may last for six months or longer. In war-related injuries, mTBI is often associated with blast exposure. The causes of dizziness or imbalance following mTBI and blast injuries have been linked to white matter abnormalities, diffuse axonal injury in the brain, and central and peripheral vestibular system damage. There is some evidence that the otolith organs may be more vulnerable to damage from blast exposure or mTBI than the horizontal semicircular canals. In addition, benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder following head injury that is treated effectively with canalith repositioning therapy. Treatment for (non-BPPV) mTBI-related vestibular dysfunction has focused on the use of vestibular rehabilitation (VR) augmented with additional rehabilitation methods and medication. New treatment approaches may be necessary for effective otolith organ pathway recovery in addition to traditional VR for horizontal semicircular canal (vestibulo-ocular reflex) recovery.
本文的目的是回顾关于轻度创伤性脑损伤（mTBI）和爆炸伤对前庭系统影响的相关文献。头晕和平衡失调是与mTBI相关的常见后遗症，在一些个体中，这些症状可能持续六个月或更长时间。在与战争相关的损伤中，mTBI常与爆炸暴露有关。mTBI和爆炸伤后头晕或平衡失调的原因与白质异常、脑内弥漫性轴索损伤以及中枢和外周前庭系统损伤有关。有一些证据表明，耳石器官可能比水平半规管更容易受到爆炸暴露或mTBI的损伤。此外，良性阵发性位置性眩晕（BPPV）是头部受伤后常见的前庭疾病，通过耳石复位疗法可有效治疗。（非BPPV）mTBI相关前庭功能障碍的治疗重点是使用前庭康复（VR），并辅以其他康复方法和药物。除了传统的用于水平半规管（前庭眼反射）恢复的VR外，可能还需要新的治疗方法来有效恢复耳石器官通路。
