Clinical and Vestibular Assessment of Vertigo Following Head Concussion: A Prospective Observational Study

Head concussion, or mild traumatic brain injury (mTBI), is a frequent presentation in emergency and outpatient settings. A significant proportion of patients with mTBI experience vestibular symptoms, including vertigo, dizziness, imbalance, and visual instability. These symptoms may stem from peripheral causes (e.g., benign paroxysmal positional vertigo—BPPV, labyrinthine concussion) or central causes (e.g., brainstem or cerebellar dysfunction), making timely diagnosis and management essential. Underdiagnosis and Mismanagement: Vestibular symptoms post-concussion are frequently under-recognized and misattributed to non-vestibular causes, resulting in incomplete assessment and treatment. Lack of interdisciplinary coordination among neurologists, ENT specialists, and physiotherapists further delays appropriate care. In resource-limited settings like Bihar, the challenge is compounded by the scarcity of trained personnel and diagnostic infrastructure for vestibular assessment. Need for Objective Evidence: There is a dearth of systematic, prospective data from India—particularly from Bihar—on the type and extent of vestibular dysfunction following concussion. Most available literature is from Western populations with different healthcare access and injury patterns. An observational study involving bedside testing and vestibular evaluations can provide vital local data to guide clinical practice and policy in such regions. Potential Impact: This study will help define the clinical spectrum of post-concussive vertigo. It will assess the diagnostic utility of bedside vestibular tests in identifying treatable causes of dizziness. It will help establish referral pathways and integrate vestibular physiotherapy into concussion care protocols. It will lay the foundation for future interventional studies targeting early recovery and rehabilitation of concussion-induced vertigo. Conclusion: Given the clinical burden, patient suffering, and diagnostic ambiguity surrounding post-concussive vertigo—especially in tertiary centers catering to underserved populations—this study is both timely and clinically relevant. It aims to bridge the knowledge and practice gap in the diagnosis and management of dizziness following head concussion in Bihar.