Constant Ringing to Pulsatile Tinnitus (Both Reactive) Post Concussion

I suffered a severe concussion 10 weeks ago during a fall. Initially I had constant ringing in my right ear (unilateral tinnitus) which is now more of rhythmic pulsatile tinnitus. It is also reactive and can increase with certain sounds. I guess it's one of the symptoms of post concussion.

Some mornings I wake up and then the first 1-2 hours the tinnitus is VERY quiet. Only up during the day it is incredibly loud (especially if stress myself), and if i'm exhausted/overworked and been in a noisy environment then i get full blown ringing in the ears.

Oddly enough I have normal hearing passing all my tests. I'm wondering if anyone else on this board had tinnitus brought on by head injury and if they also went through different stages of Tinnitus?

 

Hi Martin. I've had pulsatile tinnitus for 8 months now. Mine is a hissing that is in sync with my heart beep. I also had a severe concussion 60 days prior to when my pt started. Most doctors felt the concussion and my PT weren't related due to the 60 days in between. But I will always wonder if the concussion and the PT are connected.

Did your tinnitus start right after your concussion?

 

Martin
About 8 months into my T I suffered a concussion (I gave it my all but the cement wall bested me ); it did nothing to my T, even though I have somataform T with a very cranky upper cervical (no cartilage). It would seem logical (even reasonable) a hit to the nogin would be causal (since it makes your ears ring in the first place); however, T has many etymologies and is likely far more complex than a cracked coconut.

Mark

 

Hi Billy-

My T came on the 2nd or 3rd day after my concussion. The 1st few days i recall it was difficult to hear well out of my right ear.

I'm still very sensitive to sounds, where my T is reactive.

What i cannot figure out is if my auditory pathway is hypersensitive to sound and thus hearing my blood flow post concussion or in fact if there is some sort of vessel damage, inter cranial pressure, or a damaged capillary. both MRI/MRA/CT came back normal. However i do feel tingling and bubbling (like if you were to open a soda can) at times in my head.

It's really annoying and i sure hope to get over this to return to a normal life.

 

Hi Mark-

I never had T until my head injury. It came on 2 days after my concussion. It's been changing frequencies. At first it was really loud and fortunately of late it's been getting slightly better. I hope for it to completely fade however I don't know the best treatment if it is fluid or inflammation related...

my other thought is it could be capillary damage in the ear drum. i can't imagine and MRA/MRI would see that?

 

Hi Martin, I found something useful for us on the web and am following some of it. Please read on .

The injured brain needs to do two things, First, it needs to cleanse itself of the toxic remnants of the injury. Second, it needs to regain strength (heal) in the damaged areas. B vitamins are the most important. I suggest:

B-12 (500 to 1000 mcgs daily)
a B-50 complex, for all the other B's so you get a good balance of B's
a high potency multi-vitamin like GNC Mega. Centrum and One a Day are too weak.
Some extra anti-oxidants, Vit C and Vit E
D3, plenty of this, 1000 to 5000 iu's
Omega 3, 6, 9 fish oil
Calcium with magnesium

It will certainly help with other concussion symptoms and to some extent with T maybe. Also get a higher frequency hearing loss test done if you haven't already

 

Very interesting posts here. And VERY similar experiences.

I had brain surgery to remove a tumor called a meningioma sitting on the left parietal lobe of my brain. Everything was normal, and I passed all the Physical Therapy/Occu Therapy tests which was their greatest concern. 12 days later the T started and hasn't let up, but it peaked in November and is now what the OP describes, not rhythmic but more an occasional zing or at it's worst a full blow mini lightsaber fight like one other poster described.

Wonderful to know about the vitamins and I will try it.

My neurologist who is great tried me on amitryptilin but that has been linked to T and ear problems, I'm on my first week of topomax now to try to hit it like it's a headache/migraine I can hear. They also prescribe it for post-concussive disorder. Wish me luck, it's pretty sedating.

Very interesting to hear about this and I always thought mine was different from other posters because of the TBI like qualities it had, and it is ALWAYS changing, like every week to 10 days it's a different sound, tone. Sometimes I can hear 5 different ones when they are all going. Freaks me out.

Thank you again Asian.

 

Hey,

I know this is an old post. But i also have a very similar experience. 2.5 months ago i got post concussion syndrome, which is mostly healed except for the T. The T actually got worse and worse and is now to a point where i haven't slept nor eaten decent for weeks.

I was wondering if the T for one of you eventually went down? It's very scary that it's only getting worse.

Unfortunately there is very few information about T after concussion, so i thought i could ask you guys about your experiences.

 

Hope all is well. I've been reading some your posts and seem like you have similar case as me. I'm a kickboxer and recently got concussed. I got kicked on the left side of my head above the ear. It's been 1 week since it had happened. I have mild titnitus in the left (side of contact). On the right side pretty annoying sometimes it goes over white noise or daily noise. I also have trouble sleeping. My right ear is sensitive to certain noises and i feel pressure. It started off a lot suddenly and became more intense. I have scheduled appointments with neurologist but I have the feeling they are gonna tell me PCS and then I have to go to a ENT. Anyways I'm going through this concussion thing. I really hope yours went away forever. God bless.

 

Hey Roman, unfortunately it's still there but it's getting milder. These things can take time (from weeks to months, even years if you're unlucky but that's rather rare) Since it's only a week chances are high it will fade soon. Yes the neuro will probably just say pcs and rest some more. But it's necessary to go to a neuro and ent to rule out more serious conditions.

If the tinnitus still persist after a few weeks i recommend going to a physiotherapist to check if you don't have a muscle injury in the neck or jaw area (which is very common for pcs). They recently found out I have a neck and jaw injury rather than pcs. So the tinnitus doesn't come from my brain but from tensed up muscles that was a result of the blow. This is a somewhat treatable form of tinnitus. I started physiotherapy 2 weeks ago and there is a significant decrease in volume.

Hope yours just fade by itself.

Best of luck

 

Ok glad to hear that thank you for your input. I really appreciate it. I've been paranoid about this. It's not the easiest knowing what's wrong. I'm sure you know the feeling. Yet again thank you and appreciate the response.

I do have soreness in the neck and pain from time to time.

 

No problem i know concussion can be scary. It took 3 months for my concussion to heal because it was a severe one. The best thing is trying not to worry. I know it's hard but stress really makes a concussion heal slower. This is because when you stress your body goes into fight/flight mode and thus uses more energy and tense up muscles even more. Try to get your mind of of things if possible. Most of the times these things really go away in a few weeks.

For the neck soreness. I would suggest keeping a good posture, like not sleeping on your belly for example. Also try to prevent inflamation of the muscles (you can ask the doctor for advise on that). You can also ask the doc about physiotherapy but ideally they want to wait at least 3 weeks to start treatment.

Hope you don't have to suffer as long as i did. Stay strong!

 

If you dont mind me asking would recommend a chiropractor or just physical therapy. Or does a physical therapist recognize if you need to go to a chiropractor

 

That's more of a personal choice since they have a very similar skillset. Personally i like physio more because they focus more on soft manipulations. Hard (spine) manipulations aren't needed for a concussion unless you have some deviation in your spine (which is rare in a concussion). I have it though because the force of the impact was very big. Physio corrected it, so it's the same if you go to chiro or physio.

Have you gone to the neuro or ent yet? Most often they want to examinate you first before starting treatment. My physio wanted to know the results before starting treatment. So they know it's only muscle damage and no brain nor ear damage.

I know it's hard to relax with all this, but these things really just heal on their own in time. My nephew had tinnitus from a concussion for 3 weeks, then it just stopped. My doctor also told me that treatment is only needed when a concussions last for months because that shows that there are other injuries instead of the concussion itself. They probably will not treat you in the first weeks. So try to relax for now and let your body fix it on itself.

Are you feeling a bit better btw?

 

Going to a neuro doctor in a couple of days. It takes awhile for some reason to get to one. But I'm almost 2 weeks into concussion/neck injury and the ringing is still there, it has not decreased. Not sure if anything is supposed to change or not. But I hope yours is gone from doing therapy. Hopefully i will get answers from a the neuro doctor

I'm just scared if i have to live with this for the rest of my life at such a young age is just devastating. Also knowing that I could've prevented it.

 

Thank you Roman. I hope you don't have to suffer as long as i did. How old are you btw? I'm 25 so I'm quite young myself. I also was scared if this was going to be my life at such young age. But with time it really gets better. Trust me. My doctor told me it's very rare to have concussion symptoms for the rest of your life. But it can sometimes last for months.
Btw I'm also a neuropsych believe it or not. So I'm not unfamiliar with pcs. Believe me when i say stress and anxiety makes these injuries heal slower. Thinking this could all be avoided is not a good mindset. My accident could've been avoided too if i was more carefull. But we can't turn back time. It is what it is and we have to accept it for now. But trust me when i say time makes it better. I had horrible bilateral tinnitus. Very loud and many sounds in both ears. Now it's mostly in one ear. And for some strange reason it's very mild today (dont want to jinx it ). It took almost 4 months for it to become milder.

I hope the neuro and ent will give you good news. It will probably take some time to get a scan depending on how busy the hospital is. Do you suffer from other concussion symptoms beside tinnitus? I was also wondering if you have bilateral tinnitus or just one ear?

 

I'm 17. One more day until I go to a neuro doctor. I think it might have to do with TMJ injury maybe because I can change the pitch by biting down but I'm not sure if it's TMJ related. It's also in both ears. The other symptoms I suffer is I'm a little sensitive to sound but that seems to be fading away but that's it.

 

Wow good find Roman. It took me months to realise i could modulate it through movement. Sounds indeed jaw related. Maybe inflamation of the jaw. Definitly tell this to the neuro so he/she knows to pay attention to your jaw. A scan can rule out a misaligned tmj. You can also ask the neuro for a possible appointment with a physiotherapist or chiro if you want. I have to say, you do know a lot of tinnitus. Most people don't even know that it can be caused by tmj or neck injury.

Good luck with the neuro tomorrow!

 

Do you think it can be curable if it's from head or neck? Also did you feel like the ringing was also in your head?

 

Like i said. Time is the biggest healer. No doctor can undo a concussion or injury with a magical pill. Tinnitus itself is not a dissease it's a symptom of a injury, disease, stress, etc. If the injury heals tinnitus most likely goes away. It's like having pain when you break bones. The pain goes away when the injury heals.

Nobody can forecast the outcome of a concussion. It can take weeks, months and sometimes years. But having permanent damage is very unlikely. It just takes a lot of patience. A close relative of mine also had somatic tinnitus from neck surgery. His went away after approximately 3 months. It just stopped because his neck was healed. He told me to stop thinking about it and let my body do it's thing to heal.

If scans show no brain damage and the ent examination show no ear damage it will most likely go away. Physio can help a lot if you keep suffering from symproms. When is your ent visit btw? And how was the neuro visit?

To answer tour question of hearing it inside your brain. Yes that's possible.

 

Sorry about the late response (instructed to not go on phone tv etc) but I went to neuro and he said he 100% guarantees it will go away in 2 weeks. But coming up on week 2 since he has told me and has not seemed to fade that much. I also asked if it has to do anything with my neck and he said no. Trying to stay positive with this and hopefully get some more answers soon. I'd also like to say I did have head protection and a mouth guard in so I don't think I had any permanent brain damage I hope. But how is yours?

 

It's good you avoided screen time. It's important in the early stages of concussions.
I only semi agree with what your neuro said. I agree that the chances are very high that it will go away. But saying a 100% garantuee is just to calm you. I'm a neuropsych, when people are very anxious about a symptom i also need to reasure them that something will most likely go away with time if they dont have any visable brain damage. We can never be a 100% sure. I would rather say 99% because having permanent tinnitus after concussion is rare.
The 2 weeks mark is also to reassure you. My neuro also said my concussion would a 100% heal withinh maximum 2 weeks (i went to the neuro a month after the concussion). I took at least 3 months. And I'm 5 months later with tinnitus. The neuro didnt know i also work in the medical sector and can acces medical reports. When i read it it stated "patient will MOST LIKELY fully heal. I calmed her with giving a good prognosis".
So i went to another neuro who was more honest. He said it is impossible to give a timeline. It can take weeks, months, a year. But it almost always will fully heal.

I also dont believe you have permenant brain damage. Dont worry about that. My husband had several concussions. I had several minor and 2 severe (i did competition taekwondo + 2 hit and run accidents). We have a normal life withouth permanent brain problems. i only have tinnitus but that is now confirmed to be a neck and jaw muscle injury. My first neuro btw also told me there is no neck connection with the tinnitus when i asked and said it was probably a brain thing. A doctor can't see neck or jaw injury from the outside, so i find it weird why our neuros are so fast to jump on conclussions.

And thank you for asking how it is. My tinnitus became much better volumewise last week. This all because of my physiotherapist who is adressing the muscle injury. Withouth her it would probably take years for itself to go away or maybe even permanent.

I'm glad you are staying positive its the best thing you can do. That is a strong mindset for a young person. Lucky you wore a helmet. It doesnt protect from concussions but it does protect from other physical injury and more serious head injuries. So yeah i won't worry. I'm hoping it will go away soon for you. With these types of injuries it can really go away from 1 day to another. But if it stays go for a physio examination.

Did you already visited an ent?

 

Waiting to hear from neuro again in about a week before I go to an ENT, which will probably be the next step or an MRI. I trully do thank you for your input and experiences on all of this. It definitely helps.

 

No problem Roman! I know these problems are scary and hard to understand. Unfortunately doctors don't always give a comprehensive explanation. I don't blame them, they have busy and demanding jobs. I'm in between jobs for the moment so i have to much time on my hands ;p

I know this must be a nerving period for you, waiting for tests, etc. I was frightened too, not knowing if i had hearing loss or potential brain haemorrhage. When test came out clear it was a big relief. Not knowing is the scariest part. If we could look into the future and know things would be alright, we wouldn't mind.

How are the other concussion symptoms? Are they getting better?

 

Everything basically gone beside ringing/whistling in the ears/head. Also neck tightness and cracking in the jaw when i move it sometimes but thats it. Also a little sensetive to certain sounds in the right ear

 

Sounds positive. The concussion is definitly healing. Soft tissue injury (muscle and ligament) takes at least 3 to 6 weeks to heal on its on if i remember correctly. But that's theoretical, it's different for everyone. You should be alright with good rest.

With jaw cracking, you mean a clicking sound when you open your jaw?

 

Yes

 

Sounds like a temporomandibular injury or some tension in that area. Only a doctor in person can confirm that of course. Try to relax your jaw as good as you can (no chewing gum, be mindfull about jaw clenching, ...)

 

Do you think there could be a possibility of a combination of tmj and a neck injury

 

Tmj and neck injuries often go hand in hand. Certain neck and jaw muscles are connected. A lot of people who for ex. had whiplash have some form of tmj injury. But most often the tmj issue would be mild and unnoticed. This also happens vice versa. In my case i have a neck injury and jaw injury.

But this doesn't have to be in your case. Try not to worry about possibilities to much. Let the doctor deside if you have a neck or tmj injury. If you suspect a tmj and neck injury try to discuss it with the doctor. Tell him your neck and jaw hurts so he knows to pay attention on those areas.