TY - JOUR
T1 - Olfactory dysfunction in patients with head trauma
AU - Doty, Richard L.
AU - Yousem, David M.
AU - Pham, Lynda T.
AU - Kreshah, Allyson A.
AU - Gechle, Rena
AU - Lee, V. William
PY - 1997/9
Y1 - 1997/9
N2 - Background: The ability to smell is commonly altered by head trauma (HT). However, the nature, prevalence, prognosis, and etiology of such alterations are poorly understood. Objectives: To quantitatively determine the degree of olfactory function in patients with HT-related chemosensory complaints and to examine the influences of age, sex, HT severity, time since HT, and other variables on such function. Also, to use quantitative magnetic resonance imaging (MRI) to establish whether and to what degree damage to the olfactory bulbs and tracts, frontal lobes, and temporal lobes occurs. Patients and Methods: Two hundred sixty-eight patients with HT from the University of Pennsylvania Smell and Taste Center, Philadelphia, were administered a quantitative odor identification test, a depression inventory, and a medical history questionnaire; 66 were retested after individual test- retest periods ranging from 1 month to 13 years. The volume of olfactory- related brain structures was determined in 15 patients and 15 controls using MRI. Results: One hundred seventy-nine patients (66.8%) had anosmia, 55 (20.5%) had microsmia, and 34 (12.7%) had normosmia. Frontal impacts produced less dysfunction than back or side impacts. Of the 66 retested patients, 24 (36%) improved slightly, 30 (45%) had no change, and 12 (18%) worsened; only 3 patients, none of whom initially had anosmia, regained normal olfactory function. Trauma Severity was related to olfactory test scores in patients with microsmia. Parosmia prevalence decreased from 41.1% to 15.4% over an 8- year posttrauma period. Olfactory bulb and tract volumes of male, but not female, patients with FIT were greatly reduced relative to volumes of controls. Conclusions: Patients complaining of HT-related olfactory dysfunction typically have anosmia and rarely regain normal olfactory ability, parosmia prevalence decreases over time in such patients, and damage to olfaction-related brain structures can be observed in most such patients using an appropriate MRI protocol.
AB - Background: The ability to smell is commonly altered by head trauma (HT). However, the nature, prevalence, prognosis, and etiology of such alterations are poorly understood. Objectives: To quantitatively determine the degree of olfactory function in patients with HT-related chemosensory complaints and to examine the influences of age, sex, HT severity, time since HT, and other variables on such function. Also, to use quantitative magnetic resonance imaging (MRI) to establish whether and to what degree damage to the olfactory bulbs and tracts, frontal lobes, and temporal lobes occurs. Patients and Methods: Two hundred sixty-eight patients with HT from the University of Pennsylvania Smell and Taste Center, Philadelphia, were administered a quantitative odor identification test, a depression inventory, and a medical history questionnaire; 66 were retested after individual test- retest periods ranging from 1 month to 13 years. The volume of olfactory- related brain structures was determined in 15 patients and 15 controls using MRI. Results: One hundred seventy-nine patients (66.8%) had anosmia, 55 (20.5%) had microsmia, and 34 (12.7%) had normosmia. Frontal impacts produced less dysfunction than back or side impacts. Of the 66 retested patients, 24 (36%) improved slightly, 30 (45%) had no change, and 12 (18%) worsened; only 3 patients, none of whom initially had anosmia, regained normal olfactory function. Trauma Severity was related to olfactory test scores in patients with microsmia. Parosmia prevalence decreased from 41.1% to 15.4% over an 8- year posttrauma period. Olfactory bulb and tract volumes of male, but not female, patients with FIT were greatly reduced relative to volumes of controls. Conclusions: Patients complaining of HT-related olfactory dysfunction typically have anosmia and rarely regain normal olfactory ability, parosmia prevalence decreases over time in such patients, and damage to olfaction-related brain structures can be observed in most such patients using an appropriate MRI protocol.
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U2 - 10.1001/archneur.1997.00550210061014
DO - 10.1001/archneur.1997.00550210061014
M3 - Article
C2 - 9311357
AN - SCOPUS:0030783056
VL - 54
SP - 1131
EP - 1140
JO - Archives of Neurology
JF - Archives of Neurology
SN - 0003-9942
IS - 9
ER -