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14.11.2015
Fifteen neuro-otological patients have been investigated for post-traumatic vertigo, hearing loss and tinnitus. The neurotological clinical manifestations of posttraumatic vestibular lesions demonstrate variation.
Accidental head injury and its sequelae constitute major medical problems in Europe and America. The Glasgow Coma Scale has reported data from 1248 patients: 21% had severe head trauma, 24% moderate, and 55% minor head injuries. Craniocorpography (CCG) is a simple and more rapid method for the evaluation of vestibular function than Computerized Electronystagmography (CNG).4,5,6 Both techniques were performed in a group of 15 patients with post-traumatic vertigo in an attempt to establish the value of each test for the identification of the site of lesion.
The clinical charts of all patients with a diagnosis of posttraumatic vertigo between 1990 - 1995 seen at the Audiologic and Otoneurology Clinic were reviewed. Sex, age, type and degree of head trauma, time interval that elapsed between the onset of head trauma and the complaints of hearing loss, tinnitus and vertigo, results of audiologic and otoneurologic studies were recorded. The history included questions to elicit complaints reflecting involvement of other cranial nerves. CCG is a test initially developed as a screening procedure in occupational medicine for patients with the chief complaint of vertigo.
CNG was performed with both horizontal and vertical leads to record extra-ocular eye movements.
Fifteen neurotological patients with a diagnosis of posttraumatic vertigo were selected for this study.
All completed the neurologic examination including the history form NODEC IV (Germany) and Neurophysiology Otoophthalmologic (Argentina) ENT examination, CCG, and ENG tests.
The incidence of occurrence of head trauma and post traumatic vertigo was found to be greater in male patients by a ratio of 2 to 1. Evaluation of the Craniocorpography (CCG) and Computerized Electronystagmography (ENG) revealed an association between both.


Fifteen patients with the diagnosis of post-traumatic vertigo completed a neurotologic examination which included audiometry and equilibriometry tests.
CCG is considered a useful test in the diagnosis of central and peripheral lesions of the vestibular system secondary to head trauma.
The incidence of occurrence of head trauma and posttraumatic vertigo was found to be greater in male patients by a ratio of 2 to 1. CCG and the Butterfly Calorigram are considered significant tests to establish the diagnosis of central and peripheral lesions of the vestibular system secondary to head trauma. Clinical examination and laboratory tests included audiometry and equilibriometry in all patients.
Correlations for vertigo with the type of head trauma, nystagmus frequency, Slow Phase Velocity (SPV), and associated complaints of hearing loss and tinnitus were analyzed. A detailed questionnaire (NO DEC IV (Germany); and Neurophysiology Otoophthalmologic (Argentina) ENTexamination was completed for each patient. The past history was explored to identify underlying disease with emphasis on past or recent post-traumatic vertigo.
The test is simple to perform, less time consuming, objective, and a quantitative equilibriometric test. The polygraphic Electronystagmogram was analyzed for coordinated or dissociated eye movements. Localization of peripheral vestibular disease can be easily differentiated from central states of dysequilibrium. The correlation of SPY and frequency of 40ºC left ear with LD right suggests an indirect response of the site of lesion and a central lesion. On the other hand the SPY right 40ºC showed a direct response suggesting a peripheral lesion.
Claussen CF, De Sa J: Clinical Study of Human Equilibrium by Electronystagmography and Allied Tests.


Hickey SA, Ford GR, Buckley JG, Fitzerald O-Connor: Unterberger stepping test: a useful indicator of peri pheral vestibular dysfunction? Claussen CF, Schneider D, Marcondes LG, Patil NP: A computer analysis of typical CCG Patterns in 1021 Neuro-otological Patients. It is more frequent in men than women with a ratio of 2 to 1; and was found of increased incidence of occurrence in patients age 20 and above. Vertigo was categorized to be of five sub-groups: tilting, lift, rotation, falling, and blackouts. The methods of statistical analysis included Chi Square and Pearson's for dependence or independent variable; and Spearman correlation for association.
In our series a significant associated complaint in patients with post-traumatic vertigo was identified.
Correlations for vertigo with the type of head trauma, nystagmus frequency Slow Phase Velocity (SPV) and associated complaints of hearing loss and tinnitus were analyzed.
Neurootological symptoms like vertigo and tinnitus were subjectively difficult to describe and to classify; and frequently varied over time and following treatment. It provides a photographic, quantifiable record using a video-camera and a computer that receives, analyzes, and prints physiologic graphic significant data of the response of the patient to stimulation by stepping and standing. Some authors consider vertigo to be a consequence of the concussion and not due to alteration only of the ear. Head trauma is well recognized as a cause of vertigo and is a common disturbance of the nervous system.



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