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Fifteen months ago this patient had a skiing accident, which represented his seventh concussion. Since that time he had constant low pressure headaches, dizziness and extreme light sensitivity. He had exertional vestibular dysfunction that was predominately gravitational receptor in nature. He also experienced significant cognitive dysfunction and altered spatial orientation. Treatment for migraine and vestibular migraine did not improve his symptoms. A moving platform pressure test revealed that he had a very strong response on the right, consistent with a perilymph fistula. A weaker response was present on the left suggesting the possibility of a left perilymphatic fistula. The first video clip was recorded approximately two weeks before surgery and the second video clip was recorded April 12, 2012, the day after his surgery.