Dizziness, vertigo, headaches, neck pain, and balance problems are common after a concussion or car accident. However, these symptoms may not come from the injured brain alone.
The inner ear, eyes, neck, and autonomic nervous system all send important information to the brain. When those systems stop working together properly, a patient may experience symptoms that are difficult to explain or treat.
During this episode of Mind Matters: Navigating Head Injuries and Concussions, legal nurse consultant Kiley Como continued her conversation with Dr. Eric Reese of the Neural Connection about vestibular disorders, cervical instability, and the widespread effects of head and neck injuries.
When Vertigo Comes From the Inner Ear
Benign paroxysmal positional vertigo, commonly called BPPV, is an inner-ear condition that can cause sudden episodes of spinning or movement.
A person with BPPV may feel intense vertigo when rolling over in bed, turning their head, looking upward, or reaching for something on a shelf. The symptoms may last only a few seconds, but they can be extremely disruptive.
Patients often learn which movement triggers the dizziness and begin avoiding it.
BPPV can occur with or without a brain injury. Dr. Reese explained that some cases may also be associated with inflammation, thyroid conditions, anatomical differences, or other health factors.
Treatment may involve repositioning techniques such as the Epley maneuver, which is designed to move displaced inner-ear crystals into a less disruptive position.
The Inner Ear Does More Than Control Balance
The vestibular system helps the brain understand movement, gravity, and the body’s position in space.
Even with closed eyes, a person can usually feel when an elevator moves upward or a vehicle accelerates. That awareness comes partly from structures in the inner ear.
The vestibular system also interacts with cognition and the autonomic nervous system.
That helps explain why a sudden episode of dizziness may cause the heart rate to increase, produce anxiety, or trigger a stress response. The brain recognizes that something feels wrong and reacts protectively.
The Brain Depends on Three Important Messengers
Dr. Reese described the eyes, inner ears, and neck as three friends who attended the same event.
The brain expects all three to tell the same story.
The eyes report what the person sees. The vestibular system reports movement and gravity. The muscles and joints in the neck report the position of the head.
When all three systems provide matching information, the brain can maintain balance and stability.
After a concussion or whiplash injury, one system may begin providing information that conflicts with the others. That mismatch can contribute to dizziness, disorientation, headaches, visual problems, and difficulty moving confidently.
Why the Neck Must Be Evaluated
Neck injuries may be overlooked when a patient’s concussion symptoms receive most of the attention.
However, the neck provides a large amount of sensory information to the brain. If the neck becomes injured, unstable, or unable to report its position correctly, the eyes and vestibular system may also be affected.
Dr. Reese explained that suspected cervical instability requires careful evaluation.
Symptoms may include a feeling that the head is difficult to control, looseness in the neck, significant pain, or a sense that the neck cannot support the head normally.
When he suspects instability, Dr. Reese may refer the patient for flexion-extension X-rays or other appropriate imaging.
Cervical Instability Requires Caution
A patient with true cervical instability may require stabilization, specialist evaluation, or even surgical consultation before beginning certain physical treatments.
Dr. Reese emphasized that chiropractic adjustments, dry needling, soft-tissue work, and some forms of physical therapy may be inappropriate until instability has been ruled out.
Treating the symptoms without identifying the instability could leave the underlying problem unaddressed or potentially worsen the condition.
Early investigation matters because serious instability may place the spinal cord at risk.
Neck Injuries Can Contribute to Headaches and Jaw Pain
The effects of a neck injury may extend beyond the cervical spine.
Whiplash and head trauma can affect the trigeminal nerve system, which carries sensation through parts of the face and head.
When this system becomes irritated, a patient may experience pain around the eyes, temples, face, or jaw. It may contribute to migraine-like symptoms or temporomandibular joint problems.
The jaw, upper neck, head, and brain do not function as isolated areas. Injury and inflammation in one region may influence symptoms in another.
Brain Injuries May Disrupt Blood Flow
Normally, increased brain activity is accompanied by increased blood flow and oxygen delivery.
After a concussion or traumatic brain injury, that relationship may become disrupted. An area of the brain may be working harder while receiving less blood flow and oxygen than it needs.
This makes it more difficult to deliver nutrients and remove waste products.
Dr. Reese discussed why gradual cardiovascular exercise may help some concussion patients. When introduced safely through protocols such as the Buffalo Concussion Treadmill Test, exercise may support blood flow and help the nervous system recover.
Exercise after a brain injury should be tailored to the patient and guided by an appropriate professional.
Symptoms May Extend Into the Digestive System
Head and neck injuries may also affect the autonomic nervous system.
This system controls many functions that happen without conscious thought, including:
- Heart rate
- Blood pressure
- Digestion
- Blood flow
- Temperature regulation
- Bowel function
After an accident, patients may notice new heartburn, constipation, bloating, changes in digestion, or discomfort after eating foods they previously tolerated.
Those symptoms may seem unrelated to the collision, but Dr. Reese explained that they can be connected to changes in the brain’s automatic regulatory systems.
Patients should report these changes instead of assuming they are unimportant.
Medications Can Add Another Layer
Many injury patients take pain medication, weight-loss medication, or prescriptions for unrelated health conditions.
Some medications can slow digestion or affect the same brain and nervous-system pathways already disrupted by the injury.
For example, opioids can slow bowel function. GLP-1 medications can delay gastric emptying. These effects may complicate digestive symptoms that began after a concussion or traumatic injury.
This is why communication among providers matters.
Physicians, therapists, neurologists, chiropractors, and other professionals should understand what the patient is taking and how each treatment may affect the overall recovery plan.
Look Beyond the Most Obvious Symptom
Dizziness after a concussion may involve the brain, but it may also involve inner-ear crystals, abnormal vestibular processing, eye movements, neck injuries, or mismatched sensory information.
Headaches may be connected to the neck, jaw, blood flow, or an irritated nerve system.
Digestive problems may reflect changes in autonomic function rather than a completely separate medical condition.
Finding the cause requires a comprehensive evaluation and communication among qualified providers.
When symptoms continue after an accident, patients should describe every meaningful change, even when it seems unrelated to the original injury. Those details may help the treatment team connect symptoms that would otherwise remain separated.
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