The vestibular outcomes in non-blast related traumatic brain injury and the role of severity, aetiology and gender: a scoping review

Introduction: Traumatic brain injury (TBI) can lead to various vestibular impairments. This review explored common vestibular outcomes associated with non-blast related TBI and examined possible differences in vestibular outcomes based on TBI severity, aetiology, and gender. Methods: A scoping review was conducted using an established methodological framework, which involved electronic and manual searches of databases and journals. Records published in English were included which focused on vestibular outcomes and assessments associated with non-blast related TBI in individuals 18 years and older. Out of a total of 19.200 records, 50 met the inclusion criteria. Data were collated and categorised based on the objectives of the research. Results: Benign paroxysmal positional vertigo (BPPV) was found in 38% of 50 studies. Furthermore, despite normal peripheral vestibular function, central processing disorders such as impaired self-motion perception and sensory integration dysfunction were also observed in TBI patients. TBI severity did not have a consistent effect on vestibular outcomes, while in terms of aetiology BPPV was observed to be more common in falls related TBI. Gender differences in vestibular findings were limited and varied across studies. Conclusion: The complex nature of TBI, combined with the intricate structure of the vestibular system, makes it difficult to establish a clear framework on the vestibular outcomes following TBI. Additionally, the use of different vestibular assessment methods across studies and the inconsistent reporting of outcomes complicates the holistic analysis of the data. Therefore, in order to better understand and manage the effects of TBI on the vestibular system, it is crucial to develop standardised clinical practices and assessment guidelines.