Recurrent Vertigo Following a Mild Head Injury in a Housewife: Clinical, Psychosocial, and Daily Productivity Impacts

Abstract

Mild head injury or mild traumatic brain injury (mTBI) is a common case in Indonesia and is often considered trivial, although approximately 30–50% of patients experience residual symptoms such as vertigo, which can impact quality of life and productivity. A common problem is that post-traumatic vertigo is not properly managed due to late diagnosis and lack of patient education. This article reports the case of a 63 year old house wife with complaints of dizziness that occurs every 2-3 days with a duration of approximately 2 minutes per episode and appears erratically while sitting or doing activities. The patient had a history of a fall with a head injury three months prior accompanied by a loss of consciousness for approximately 5 minutes. Neurological examination showed impaired balance with positive Romberg and tandem tests, while the Dix-Hallpike maneuver showed no typical results. Based on the clinical presentation, the patient was diagnosed as post-concussion syndrome with the possibility benign paroxysmal positional vertigo secondary trauma. The patient was given therapy in the form of canalith repositioning maneuvers, pharmacotherapy, and education. Evaluation results showed symptom improvement, but limitations in daily activities and anxiety about recurrence persisted. This case demonstrates that post-traumatic vertigo has significant clinical and psychosocial impacts, necessitating a multidisciplinary approach for early diagnosis, optimal management, and patient education to maintain productivity