calling all vestibular whizzes!
i received a referral for a patient on ICU today (3.10.11) who came in after falling off a ladder onto the back of his head (30.9.11). CT showed a small sub arachnoid haemorrhage that they are managing conservatively.
he is improving clinically, independently mobile around the ICU, but his main problem is severe vertigo lasting less than a minute associated with head movement.
i am thinking post traumatic BPPV, but am reluctant to dix-hallpike him because of the potential for increased ICP.
the research i have found around contraindications for dix-hallpike mainly discussed cervical issues.
does anyone have an opinion/guidelines on when it is safe/appropriate to look at this type of testing in cases of TBI?