What to Know About Dizziness After a Concussion

It’s common to feel dizzy after a concussion. It usually goes away on its own within a few days to weeks. But if symptoms persist, a doctor may consider treatments, including medication or lifestyle and dietary changes.

Behind headache, dizziness is the second most common symptom of concussion. You might feel dizzy immediately after a concussion, or you might not experience symptoms until hours or days later. It’s possible you’ll also experience symptoms at different points in your recovery.

Post-concussion dizziness is usually due to an issue with the part of your brain that controls balance. But it can also stem from other causes. If your dizziness doesn’t go away after a few weeks, speak with a doctor to identify the exact cause and consider treatment options.

Dizziness stems from issues with your vestibular system. The vestibular system is a connection between your inner ear and the part of your brain that controls balance.

A concussion is a change in typical brain function that results from trauma. Such trauma can affect your vestibular system and affect your sense of balance.

In about 10% of cases, a concussion can also affect your pituitary gland, a small gland at the base of your brain. This is more common in moderate or severe traumatic brain injuries, and symptoms may not occur until later.

A moderate or severe concussion can also damage the nerves in your autonomic nervous system (ANS). This can affect your heart rate and blood pressure, which can also dizziness.

Types of dizziness

There are four types of dizziness. You can have one or more of these after a concussion.

• Vertigo: experiencing a spinning sensation
• Disequilibrium: having a loss of balance
• Lightheadedness: experiencing giddiness, or feeling unbalanced and woozy
• Presyncope: feeling faint

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People may experience dizziness after a concussion in different ways. According to research , people often report feeling:

Post-concussion dizziness typically goes away within days or weeks. According to research from 2021, it goes away within 3 weeks in 85% to 90% of cases.

Post-concussion dizziness that lasts longer than 3 weeks is usually a type of vertigo known as benign paroxysmal positional vertigo (BPPV).

In a 2021 study of 102 people under age 21 with post-concussion syndrome and dizziness, 29.4% had BPPV.

BPPV should resolve within 3 months — with or without treatment.

• loss of balance
• trouble walking
• trouble staying awake
• mental confusion
• vomiting
• seizures

Treatment for post-concussive dizziness depends on the cause. You can often manage mild dizziness at home. If it lasts longer than a few weeks, a doctor may prescribe medication or suggest lifestyle changes.

Rest

The Centers for Disease Control and Prevention (CDC) notes that it’s important to rest for a few days after a concussion. Rest also reduces your risk of another head injury, as you’ll avoid impact activities. Symptoms should resolve within a few days or under 3 weeks.

Canalith repositioning

BPPV is usually due to buildup of small crystals (canaliths) in your ear canal. If BPPV is causing dizziness, a doctor may recommend canalith repositioning to move the crystals out of the ear canal. This procedure is also known as the Epley maneuver.

Dietary changes and diuretics

Some people with long-term post-concussion dizziness experience symptoms similar to those in Meniere’s disease, an inner ear disorder. Some of the treatments that help with Meniere’s disease might also help treat post-concussion dizziness. These treatments include:

• following a low salt diet
• avoiding caffeine and alcohol
• taking diuretic medications such as hydrochlorothiazide or acetazolamide

Treatment for nonvestibular causes of dizziness

If your dizziness doesn’t go away after several weeks, a doctor might consider if there is a nonvestibular cause, such as pituitary or autonomic dysfunction, which can develop when ANS nerves are damaged.

If a doctor diagnoses an issue with your pituitary gland, which secretes hormones into your bloodstream, they may prescribe hormone replacement medications.

To diagnose autonomic dysfunction, a doctor will usually review your symptoms and plan treatment accordingly. While autonomic dysfunction may go away on its own, a doctor may recommend drinking plenty of fluids and, in some cases, undergoing physical therapy.