Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH, United States; Department of Physical Therapy, School of Health Related Professions, University of Mississippi Medical Center, Jackson, MS, United States; Department of Neurosurgery, School of Medicine, University of Mississippi Medical Center, Jackson, MS, United States.
Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH, United States.
Musculoskelet Sci Pract. 2018 Apr;34:8-13. doi: 10.1016/j.msksp.2017.11.012. Epub 2017 Nov 26.
Dizziness is commonly reported after concussion. With the forces experienced at the time of the injury, several anatomical locations may have been altered, causing dizziness.
Describe an objective examination and the types of impairment/dysfunction implicated by the results of clinical examination tests in subjects with dizziness after a concussion.
Cross-Sectional.
Athletes between ages 10-23 were enrolled with a diagnosis of concussion. An examination was completed to identify areas potentially contributing to dizziness, including tests of oculomotor control, the vestibular system, neuromotor control, and musculoskeletal components of the cervical spine. Descriptive analyses were completed to define the anatomical areas/types of dysfunction identified by positive findings of the examination tests.
All (n = 41; 100%) subjects had examination findings consistent with central dysfunction. Of these, 36 (97.8%) had oculomotor control deficits; 29 (70.7%) demonstrated motion sensitivity; and 6 (15%) had central vestibular deficits. Nineteen (46.3%) had peripheral dysfunction, including 18 (43.9%) with unilateral hypofunction, and 2 (4.9%) with Benign Paroxysmal Positional Vertigo. Thirty-four (82.9%) had cervical dysfunction, with 11 (26.8%) presenting with cervicogenic dizziness, and 31 (75.6%) with altered neuromotor control.
Functional injury to centrally-mediated pathways, specifically oculomotor control, and afferent and efferent pathways in the cervical spine are commonly identified through clinical examination tests in individuals with a complaint of dizziness post-concussion. According to results presented here, a high majority (90%) of the participants demonstrated dizziness that appeared to be multifactorial in nature and was not attributable to one main type of dysfunction. The common pathways between the systems make it difficult to isolate only one anatomical area as a contributor to dizziness.
脑震荡后常出现头晕。由于受伤时所受的力，可能有几个解剖部位发生改变，导致头晕。
描述头晕的脑震荡后患者的客观检查和临床检查测试结果提示的损伤/功能障碍类型。
横断面研究。
招募年龄在 10-23 岁之间、有脑震荡诊断的运动员。进行检查以确定可能导致头晕的部位，包括眼动控制、前庭系统、神经运动控制以及颈椎肌肉骨骼成分的检查。通过对检查测试阳性结果确定的解剖区域/功能障碍类型进行描述性分析。
所有（n=41；100%）患者的检查结果均与中枢功能障碍一致。其中，36 例（97.8%）有眼动控制缺陷；29 例（70.7%）表现出运动敏感；6 例（15%）有中枢前庭功能障碍。19 例（46.3%）有外周功能障碍，包括 18 例（43.9%）单侧功能低下和 2 例（4.9%）良性阵发性位置性眩晕。34 例（82.9%）有颈椎功能障碍，其中 11 例（26.8%）表现为颈源性头晕，31 例（75.6%）有神经运动控制改变。
通过临床检查测试，在头晕的脑震荡后患者中，中枢介导途径的功能损伤，特别是眼动控制以及颈椎的传入和传出途径，通常会被识别出来。根据这里提供的结果，绝大多数（90%）参与者表现出的头晕似乎是多因素的，并非归因于一种主要类型的功能障碍。这些系统之间的共同途径使得很难仅将一个解剖区域孤立为头晕的原因。
