Prevalence of Vestibular Disorders in Moderate-Severe Traumatic Brain Injury (TBI): A Scoping Review

Jasmine S Edwards; Chelsea J Manetta; Regan G Harrell

doi:10.1097/HTR.0000000000001141

Prevalence of Vestibular Disorders in Moderate-Severe Traumatic Brain Injury (TBI): A Scoping Review

J Head Trauma Rehabil. 2025 Dec 12. doi: 10.1097/HTR.0000000000001141. Online ahead of print.

Authors

Jasmine S Edwards¹, Chelsea J Manetta, Regan G Harrell

Affiliation

¹ Author Affiliation: Department of Physical Therapy, The University of Pittsburgh, Pittsburgh, Pennysylvania (Edwards, Manetta, and Harrell).

PMID: 41382327
DOI: 10.1097/HTR.0000000000001141

Abstract

Background: Traumatic brain injury (TBI) can cause a wide range of impairments, with moderate to severe TBI resulting in more significant disability than mild TBI. Vestibular dysfunction, which can present symptoms of dizziness, vertigo, or imbalance, is common following a TBI but has been less researched in moderate to severe TBIs.

Objective: To examine the prevalence of vestibular dysfunction in individuals with moderate to severe TBI and investigate the vestibular assessments used.

Methods: A scoping review was conducted following PRISMA-ScR guidelines. Two comprehensive searches were performed using PubMed, CINAHL, Embase, and clinical trial registries, with limitations set for the periods January 1, 1990, to November 8, 2023, and November 9, 2023, to March 27, 2025. Two reviewers screened articles by title and abstract. One reviewer performed full-text screening and final article extraction.

Results: An initial search yielded 7472 articles, of which 91 underwent full-text review, and 11 met the inclusion criteria. A second search added 589 articles, from which 7 additional studies were included. In total, 18 studies met all eligibility criteria and were included in the final review. The included studies varied in design, consisting of randomized controlled trials, cohort studies, cross-sectional studies, and retrospective reviews. Vestibular dysfunction was assessed through a range of methods, and varying metrics determined the severity of TBI. Incidence of vestibular impairments ranged between 1% and 80% in those with moderate to severe TBI.

Conclusion: Vestibular dysfunction is prevalent among individuals with moderate-to-severe TBI, although the methods of assessment vary. Future studies should aim to be more consistent in documenting the severity of TBI, the evaluation of vestibular dysfunction, and determining interventions that are most beneficial for this population.

Keywords: dizziness; traumatic brain injury; vertigo; vestibular disorder.