Document Detail

Anosmia after aneurysmal subarachnoid hemorrhage.
MedLine Citation:
PMID:  18091268     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Anosmia has an important impact on well-being but is often neglected by physicians. In patients with subarachnoid hemorrhage (SAH), anosmia has mainly been reported after surgery for aneurysms of the anterior communicating artery. We studied the prevalence, predisposing factors (aneurysm site and type of treatment), impact, and prognosis of anosmia in patients with SAH. METHODS: Of the patients with SAH who resumed independent living, we included all patients treated by coiling between 1997 and 2003 and a sample of patients treated by clipping between 1985 and 2001. Patients underwent structured interviews regarding the presence and duration of anosmia. The impact of anosmia was scored using a visual analog scale ranging from 0 (no influence) to 100 (the worst thing that ever happened to them). Risk factors for anosmia were assessed by logistic regression analysis. RESULTS: Overall, 89 of the 315 interviewed patients (28%; 95% confidence interval [CI], 23-34%) reported anosmia after SAH (mean follow-up period, 7.4 yr), including 10 (15%) of the 67 coiled patients and 79 (32%) of the 248 clipped patients. The median visual analog scale impact score was 53 (range, 0-100). In 20 of the 89 patients (23%; 95% CI, 15-33), the symptoms had improved over time. Risk factors for anosmia were treatment by clipping (odds ratio [OR], 2.7; 95% CI, 1.3-5.7) and anterior communicating artery aneurysms (OR, 2.0; 95% CI, 1.2-3.3). CONCLUSION: Anosmia after SAH has a high prevalence, considerable impact, and poor prognosis. Its occurrence after coiling suggests not only damage to the olfactory nerve by clipping but also that the SAH itself plays a role in its pathogenesis.
Marieke J H Wermer; Maarten Donswijk; Paut Greebe; Bon H Verweij; Gabriël J E Rinkel
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurosurgery     Volume:  61     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  918-22; discussion 922-3     Citation Subset:  IM    
Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
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MeSH Terms
Embolization, Therapeutic / statistics & numerical data*
Middle Aged
Olfaction Disorders / epidemiology*
Postoperative Complications / epidemiology*
Risk Assessment / methods*
Risk Factors
Subarachnoid Hemorrhage / epidemiology*,  therapy*
Treatment Outcome
Vascular Surgical Procedures / statistics & numerical data*

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