Impairments of the visual and/or vestibular system can result in headaches, difficulty reading, dizziness, nausea, fatigue and even concentration problems. All of these symptoms are associated with concussions and may occur at the time of injury or be residual and associated with post-concussion syndrome (PCS).
Dizziness at the time of injury is considered the #1 predictor of PCS and headache is the most common symptom reported1. Studies also reveal that 90% of patients with mTBI have presented with oculomotor dysfunction2-3.
Although oculomotor dysfunction has been discussed more recently in regards to mild traumatic brain injury (mTBI) or “concussion,” oculomotor assessment has been a critical component to the clinical examination for patients post traumatic brain injury for 3,500 years or more4.
The following studies highlight the need for an oculomotor and a vestibular assessment to be key components of the clinical examination following any severity of head trauma:
We have much to learn about the consequences of head trauma, not only as it relates to the younger population or the long term effects of repeated concussions but how such injuries can impact more than just cognition. A growing number of studies are focusing on the impact of head trauma on both the peripheral and central visual-vestibular pathways. Health care providers agree that a neurological examination should be performed following any severity of head trauma, which would include an assessment of inner ear and oculomotor function.
Remember: the eyes are the window to the brain, therefore, utilize well established clinical tools that are reliable in identifying impairments and consider such findings when developing the most appropriate treatment plan. A comprehensive concussion management program not only includes cognitive testing but utilizes a variety of clinical tools into the return to play/return to life rehabilitation process. And, ideally, baseline testing is available to compare the status of the individual before and after the injury.
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