Among the many causes of tinnitus is head trauma, which may warrant further examination by a healthcare professional to best assess your medical needs and treatment. In fact, for more than one in ten people suffering from chronic tinnitus (ringing in the ears), the problem stems from a prior neck or head injury. These symptoms can last from a few days or weeks to several months, or even years in the most severe cases, and must be closely monitored.
These head traumas (or traumatic brain injuries, TBI) can have many neurological and physiological consequences on the body. Better known as concussions, they vary not only in severity but also in their impact on the body. It is important to consider whether you or a loved one are exposed to repeated head trauma and what impact this may have on your health and well-being, or that of your loved one.
The causes of head trauma
Head traumas have multiple origins and vary in severity, resulting in a wide range of both physiological and cognitive symptoms. Consider the risk factors that may have increased your exposure to brain injuries to better determine if you should seek medical advice. Remember that brain injuries are a serious medical issue: if you believe you have suffered a head injury, it is best to consult a healthcare professional to assess any potential damage.
Common causes of head trauma include physical activity, particularly contact sports (football, basketball, boxing), extreme outdoor sports (downhill mountain biking, downhill skiing or snowboarding, motocross), falls or trips, assaults and fights, or road accidents. If you have been frequently exposed to these activities, your risk of developing chronic brain damage due to repeated trauma is higher. Such trauma can be progressively deleterious and have a cumulative effect: the more minor injuries are repeated, the greater the risk of significant brain damage.
If head trauma causes damage, it is due to the anatomical structure of the skull in which the brain rests. The brain is bathed in a fluid, the cerebrospinal fluid (CSF), which cushions it and prevents it from being subjected to significant forces against the bones of the skull. However, during a head injury, the brain can be subjected to considerable force as it impacts the skull, leading to injury. To better understand the physical mechanism involved, imagine the brain as a soft spring placed inside the skull. If the head is moved abruptly, the brain is thrown against one wall of the skull and compresses like a spring. This compression then releases very quickly: the brain relaxes and rebounds against the opposite wall, producing a "contrecoup" effect. The brain is thus violently pushed and pulled inside the skull and hits the walls with very high force, resulting in a traumatic brain injury (TBI).
Symptoms of head trauma
Symptoms vary depending on the severity of the trauma sustained and the number of incidents over time. Furthermore, depending on your level of exposure, your symptoms may multiply or worsen over the years. Thus, a person who has suffered a single severe head injury may exhibit brain damage comparable to that of a person who has suffered multiple minor injuries.
These symptoms can signal potential brain damage. They notably include:
Physical symptoms
Loss of consciousness: dizziness, fainting, falling
Post-traumatic amnesia: inability to remember in the short or long term
Headaches / migraines: severe headaches or migraines are a common symptom after a concussion or brain injury
Dizziness: it may be difficult to maintain balance or a stable posture
Sensitivity to light: exposure to bright light can be painful
Sensitivity to sound: exposure to loud sounds can be painful
Seizures: a serious medical problem involving hyperexcitable brain activity and convulsions
Blurred vision: it may be difficult to see clearly
Dry eyes: your eyes may often be dry or irritated
Chronic pain: you may feel widespread chronic pain in the body
Cognitive symptoms
Reduced attention: head trauma can affect the prefrontal cortex and decrease your concentration or attention span
Impaired decision-making: the prefrontal cortex is also involved in decision-making, which can be disrupted by a head injury
Lack of impulse control: also linked to the functioning of the prefrontal cortex, it can manifest as impulsive behavior, such as excessive spending or reckless sexual activity
Difficulty concentrating: it can simply be difficult to focus on daily tasks
Memory lapses: you may forget what you are doing or who you are talking to
Confusion: you may be disoriented regarding your identity or your orientation in space and time
Emotional symptoms
Anxiety: generalized anxiety or nervousness can increase after a head injury
Apathy: inability to feel emotions or emotional blunting
Aggression: some people become more aggressive for no apparent reason after repeated head trauma (common in retired American football players)
Depression: mood can be blunted or depressed after repeated head trauma
Personality changes over time: a loved one may point out that your personality has evolved
Post-traumatic stress: PTSD is a frequently reported symptom among people who have experienced multiple head traumas, particularly following road accidents
Why does tinnitus appear after a head injury?
Sensitivity to sound is a normal reaction after a concussion. Some people notice that these symptoms are most pronounced in noisy places, such as supermarkets or restaurants. Remember that tinnitus consists of ringing, buzzing, or hissing sounds perceived in the ears. It can result from damage to the inner ear, the auditory nerves, or the area of the brain that processes hearing, known as the auditory cortex. Tinnitus can be permanent or intermittent. These manifestations usually fade after a certain period. However, prolonged sensitivity to sound may be a sign of underlying tinnitus.
As mentioned above, tinnitus can result from a head injury due to the whipping motion of the brain inside the skull. The injured areas attempt to adapt and recover, which can manifest as tinnitus. In this case, the auditory cortex or the hair cells (specialized nerve cells located in the inner ear) that allow us to hear and process sound may have been affected, causing these unpleasant sensations such as ringing in the ears.
According to one study, compared to other patients suffering from tinnitus, the group that had suffered a neck or head injury faced more daily difficulties related to their tinnitus. These individuals had more trouble sleeping, relaxing, thinking clearly, and remembering. They also rated the volume of their tinnitus as approximately one-third louder than other patients who had not suffered a head or neck injury. On what is known as the Tinnitus Severity Index, this places them at an average of 41.9 points, which, according to the study's authors, is significantly higher than the 38.1-point average of other patients. Therefore, take the severity of your tinnitus into account: it may be correlated with the extent of the head trauma sustained.
Managing tinnitus linked to head trauma
You may be wondering how a clinician or healthcare professional treats tinnitus following a head injury: that is what we will explore. Furthermore, those affected often find personal methods that help them better manage their symptoms.
The hearing specialist
Consulting a hearing specialist is often a wise step to understand the severity of your tinnitus and how to manage it as best as possible. They can perform various hearing tests to identify the root cause of the tinnitus and propose the most clinically appropriate treatment.
There are also various therapeutic options: medications to relieve symptoms, hearing aids to reduce or mask the noise, sound therapies for neural retraining, or behavioral therapies to limit risky exposures. Consult a specialist to determine the options most suited to your situation.
Masking
A common technique for managing tinnitus is what is known as "masking." It is often the strategy adopted by people dealing with persistent tinnitus linked to a concussion.
With masking, the patient wears a small device that resembles a hearing aid (earbuds can also be suitable). The device generates customized sounds that cover the annoying ringing associated with tinnitus.
Classic masking sounds, such as the white noise of a fan, nature sounds, or music, can also be used.
For some people, masking utilizes mechanisms of neuroplasticity and neural training that retrain the brain to ignore repetitive or annoying sounds. Eventually, the person no longer needs to use it. However, this method does not always work: most patients must rely on masking for life.
Complementary approaches
Other complementary techniques can reduce the severity of tinnitus. Tinnitus is aggravated by high stress and anxiety: finding ways to reduce your anxiety can therefore sometimes help. Here are other ways to alleviate your symptoms:
Acupuncture
Cognitive behavioral therapy
Mindfulness meditation
Physical exercise
While these methods do not treat tinnitus directly, they can help you reduce its impact on your psychological balance.
How to avoid making things worse
Ultimately, repeated brain injuries can worsen tinnitus: it is therefore beneficial to limit exposure to future head trauma and noise damage to promote recovery.
Consider using appropriate protective equipment, such as helmets, shoulder pads, or foam padding, to reduce the risk of repeated head trauma when participating in contact sports.
You can also reduce or limit your exposure to noisy environments (concerts, supermarkets, large venues) so as not to further damage your hearing or sound-processing systems. If you must go to such places, wear hearing protection such as earplugs.
Tinnitus linked to head trauma can last from a few days to several weeks, or even become a lifelong health issue. As always, consult a healthcare professional if you believe that you or a loved one are suffering from tinnitus following a head injury, in order to determine the treatments and management plan best suited to your set of symptoms.
