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This page will provide you with a comprehensive overview on the effects of traumatic anosmia, the symptoms of traumatic anosmia, and the treatment of traumatic anosmia as it pertains to stroke. Specifically, it will outline the reasons it is essential to understand the consequences of traumatic anosmia and the potential risks associated with traumatic anosmia. We sincerely hope that our website helps to further your understanding on the topic of traumatic anosmia. If you have further questions, please contact a healthcare professional.
What is traumatic anosmia?
Anosmia, the inability to perceive smell, may be a temporary or permanent disorder in a patient. The term “traumatic anosmia” specifically refers to anosmia that results from a brain trauma, and consequently permanent. This is an important distinction to make because anosmia can be due to a number of factors including, but not limited to, a blockage of the nasal passages, inflammation of nasal mucosa and destruction of the temporal lobe. For the purposes of this discussion, we will focus on traumatic anosmia as it relates to stroke.
Ischemic stroke, characterized by insufficient blood flow to the brain, can cause significant brain injury due to cell death. Specifically, the temporary hypoxic conditions associated with stroke can lead to significant irreversible brain cell death, and thus, lead to many different conditions associated with the brain. Anosmia can be caused by stroke if significant cell death occurs in the temporal lobe region or in the frontal lobes. This is because these areas are important in processing the signals received from the olfactory system.
How Olfaction Works
Before we can understand the importance of traumatic anosmia, it is crucial to understand the basic process of olfaction (smelling). Olfaction begins with an odor molecule being released from an object or substance, such as pheromones released from people. This molecule will travel up a person’s nose as they inhale, bind a receptor and stimulate olfactory cells (special nerve cells high up in your nose). After stimulating this region, signals are sent up the olfactory tract into the frontal lobes of the brain. The brain then processes this information in the orbitofrontal cortex (the lower portion of the frontal lobes) and associates the odor with specific emotions or objects. Anything that interferes with the binding or interpretation of these signals, such as nasal congestion, damaged nerve cells or temporal brain damage, can result in anosmia.
Symptoms of Anosmia
Traumatic anosmia causes a variety of symptoms that are common with regular anosmia, such as:
• Loss of appetite
• Loss of an established memory
• Loss of libido
These symptoms are very nonspecific and are somewhat rooted in behaviour. As such, they can be misdiagnosed.
Risks Involved with Traumatic Anosmia
There are a variety of safety risks when a person has a lost sense of smell and taste after head injury. For examples, some safety risks may include:
• The inability to detect spoiled food- it may cause an individual to become very sick from food poisoning.
• The inability to detect gas or toxic fumes- it may prevent an individual from evacuating the premises if an emergency arises.
• The inability to distinguish poisonous liquids from edible liquids –it may accidentally lead to consumption of the poison.
In addition to safety risks, there are also variety of psychological risks, health risks and social risks when a person has a lost sense of smell and taste after head injury. Some common risks may include:
• Depression: Our olfactory system plays an important role in our emotions
• Changes in Personal Relationships: The olfactory system in an important component of our libido
• Decreased Appetite: When a person has a lost sense of smell and taste after head injury, they find eating less pleasurable.
• Increased Use of Sugar/Salt: They may need stronger tastes to be able to appreciate food
Diagnosing Traumatic Anosmia
An important test used by physicians to diagnose traumatic anosmia is called the acetylcysteine test. This test involves asking the patient if they can smell acetylcysteine or not. If not, the doctor will ask for a detailed history of potential injury the person has had, such as respiratory infections or head injury. Next, they will perform a nervous system examination to check for cranial nerve damage. If they do not find any, they may investigate further through various “smell tests”. The doctor will check both nostrils as anosmia often occurs unilaterally (in one nostril).
Treatment of Anosmia
Treatment of anosmia often involves treating the underlying condition, such as inflammation. Unfortunately, traumatic anosmia involves brain injury and cannot be treated. However, there are a few things doctors can do to reduce the extent of traumatic anosmia. For example, if a patient suffers from a hemorrhagic stroke, the doctor can try to treat and prevent the hemorrhage from progressing. In some cases, if the progression of the haemorrhage is halted the nerves and area of the brain compressed by the hemorrhage may recover once the swelling is reduced. However, if the person’s sense of smell has not started to recover after one year, it is unlikely to do so at all.
Living with Traumatic Anosmia
Although there is no treatment of anosmia that can be used to cure traumatic anosmia, there are some small changes a person can make to live with it. For example, you can make food more appetizing and fun by using different textures, colors and spices. Importantly, although anosmia causes a person’s sense of taste to be affected, it is not completely impaired. As a result of this, spicy foods can be very appetizing. Likewise, to try and reduce safety risks a person can install extra smoke detectors, CO detectors, label all chemicals and pay close attention to expiration dates. In sum, it is critical to compensate for traumatic anosmia because olfaction plays a significant role in safety and pleasure.
For any additional information on conditions or risks traumatic anosmia causes, please contact your local healthcare professional.