Head trauma: hearing loss and dizziness.

OBJECTIVE: Because the physicians who care for patients with head trauma may be family practitioners or internists, this article provides these physicians some knowledge of the causes and pathophysiology of such trauma with respect to neurologic sequelae to aid in their decisions to seek consultation with neurologists and otoneurologists in diagnosis and management.

METHODS: This article reviews the literature concerning differential diagnosis, appropriate evaluation, and possible treatments of patients who exhibit hearing loss and dizziness after head trauma, whiplash injuries, or both. I also relate those findings to my extensive experience with such neurologic problems.

FINDINGS: The findings are grouped according to injuries that cause dizziness, including trauma to the brain stem - eighth nerve complex, the semicircular canals (labyrinthine concussion), benign paroxysmal positional vertigo, Meniere's syndrome -- vestibular symptoms, perilymphatic fistula -- vestibular symptoms, and cervical vertigo; and those that cause hearing loss, including trauma to the brain, eighth nerve, middle ear, cochlear concussion, Meniere's syndrome, and perilymphatic fistula.