Olfactory Testing Informs the Decision Process to Obtain Advanced Neuroimaging in Traumatic Brain Injury
Abstract The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting,...
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| Veröffentlicht in: | Military medicine 2018-03, Vol.183 (suppl_1), p.321-326 |
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| creator | Shih, Robert Xydakis, Michael |
| description | Abstract
The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting, in contrast to deficits in other senses like vision or hearing. This is a retrospective clinical analysis (case series) of eight active duty service members referred to ear, nose, and throat clinic at Walter Reed National Military Medical Center during a 2-yr period between March 2014 and March 2016 for subspecialist evaluation of suspected olfactory impairment after an exposure to closed head trauma. Advanced neuroimaging revealed evidence of frontal lobe injury in all eight patients, which was subtle and subcentimeter in half of the cases, best demonstrated with high-resolution imaging in the coronal plane. In this article, we discuss the correlation between olfactory dysfunction and brain pathology in both TBI and non-TBI settings. We then provide our recommendation for an orbit magnetic resonance imaging (MRI) to evaluate the inferior frontal lobes and olfactory bulbs in patients with unexplained anosmia. |
| doi_str_mv | 10.1093/milmed/usx178 |
| format | Article |
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The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting, in contrast to deficits in other senses like vision or hearing. This is a retrospective clinical analysis (case series) of eight active duty service members referred to ear, nose, and throat clinic at Walter Reed National Military Medical Center during a 2-yr period between March 2014 and March 2016 for subspecialist evaluation of suspected olfactory impairment after an exposure to closed head trauma. Advanced neuroimaging revealed evidence of frontal lobe injury in all eight patients, which was subtle and subcentimeter in half of the cases, best demonstrated with high-resolution imaging in the coronal plane. In this article, we discuss the correlation between olfactory dysfunction and brain pathology in both TBI and non-TBI settings. We then provide our recommendation for an orbit magnetic resonance imaging (MRI) to evaluate the inferior frontal lobes and olfactory bulbs in patients with unexplained anosmia.</description><identifier>ISSN: 0026-4075</identifier><identifier>EISSN: 1930-613X</identifier><identifier>DOI: 10.1093/milmed/usx178</identifier><identifier>PMID: 29635584</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Brain Injuries, Traumatic - diagnosis ; Clinical Competence - standards ; Decision Making ; Head injuries ; Humans ; Magnetic Resonance Imaging - methods ; Male ; Middle Aged ; Military personnel ; Neuroimaging ; Neuroimaging - methods ; Neuroimaging - trends ; NMR ; Nuclear magnetic resonance ; Olfaction disorders ; Olfactory Perception - physiology ; Retrospective Studies ; Sensory perception ; Smell ; Traumatic brain injury</subject><ispartof>Military medicine, 2018-03, Vol.183 (suppl_1), p.321-326</ispartof><rights>Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US. 2018</rights><rights>Copyright Association of Military Surgeons of the United States Mar/Apr 2018</rights><rights>Published by Oxford University Press on behalf of Association of Military Surgeons of the United States 2018. This work is written by (a) US Government employee(s) and is in the public domain in the US.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c377t-4de00862c28d4d46a67d789e3d6e27333aa2518112a14db8fae58dc8c1a0149a3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29635584$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shih, Robert</creatorcontrib><creatorcontrib>Xydakis, Michael</creatorcontrib><title>Olfactory Testing Informs the Decision Process to Obtain Advanced Neuroimaging in Traumatic Brain Injury</title><title>Military medicine</title><addtitle>Mil Med</addtitle><description>Abstract
The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting, in contrast to deficits in other senses like vision or hearing. This is a retrospective clinical analysis (case series) of eight active duty service members referred to ear, nose, and throat clinic at Walter Reed National Military Medical Center during a 2-yr period between March 2014 and March 2016 for subspecialist evaluation of suspected olfactory impairment after an exposure to closed head trauma. Advanced neuroimaging revealed evidence of frontal lobe injury in all eight patients, which was subtle and subcentimeter in half of the cases, best demonstrated with high-resolution imaging in the coronal plane. In this article, we discuss the correlation between olfactory dysfunction and brain pathology in both TBI and non-TBI settings. We then provide our recommendation for an orbit magnetic resonance imaging (MRI) to evaluate the inferior frontal lobes and olfactory bulbs in patients with unexplained anosmia.</description><subject>Adult</subject><subject>Brain Injuries, Traumatic - diagnosis</subject><subject>Clinical Competence - standards</subject><subject>Decision Making</subject><subject>Head injuries</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging - methods</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Military personnel</subject><subject>Neuroimaging</subject><subject>Neuroimaging - methods</subject><subject>Neuroimaging - trends</subject><subject>NMR</subject><subject>Nuclear magnetic resonance</subject><subject>Olfaction disorders</subject><subject>Olfactory Perception - physiology</subject><subject>Retrospective Studies</subject><subject>Sensory perception</subject><subject>Smell</subject><subject>Traumatic brain injury</subject><issn>0026-4075</issn><issn>1930-613X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkb1v2zAQxYmgQeMkHbsWBLp0UXz8kEiOTpoPA0acwQW6CTRJOTIk0SHFov7vI8EJAmRIpgPufvdw7x5C3wlcEFBs2tZN6-w0xf9EyCM0IYpBVhD29wuaANAi4yDyE3Qa4xaAcCXJV3RCVcHyXPIJelw2lTa9D3u8crGvuw2ed5UPbcT9o8O_nalj7Tv8ELxxcWh6vFz3uu7wzP7TnXEW37sUfN3qzbg8DFZBp1b3tcGXYQTn3TaF_Tk6rnQT3beXeob-3Fyvru6yxfJ2fjVbZIYJ0WfcOgBZUEOl5ZYXuhBWSOWYLRwVjDGtaU4kIVQTbtey0i6X1khD9OhOszP066C7C_4pDZbKto7GNY3unE-xpEA5kJxSNqA_36Fbn0I3XFdSzgAUBUY-pIArJRQRMFDZgTLBxxhcVe7C8JOwLwmUY1DlIajyENTA_3hRTeux_Uq_JvPmw6fdJ1rP4ZCdoA</recordid><startdate>20180301</startdate><enddate>20180301</enddate><creator>Shih, Robert</creator><creator>Xydakis, Michael</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4T-</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88F</scope><scope>88G</scope><scope>88I</scope><scope>8AF</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M1Q</scope><scope>M2M</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20180301</creationdate><title>Olfactory Testing Informs the Decision Process to Obtain Advanced Neuroimaging in Traumatic Brain Injury</title><author>Shih, Robert ; 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The purpose of this article is to examine the usefulness of olfactory testing as a tool for the evaluation or stratification of traumatic brain injury (TBI) patients. Olfactory dysfunction is more likely to be overlooked by both the patient and the provider, especially in the acute setting, in contrast to deficits in other senses like vision or hearing. This is a retrospective clinical analysis (case series) of eight active duty service members referred to ear, nose, and throat clinic at Walter Reed National Military Medical Center during a 2-yr period between March 2014 and March 2016 for subspecialist evaluation of suspected olfactory impairment after an exposure to closed head trauma. Advanced neuroimaging revealed evidence of frontal lobe injury in all eight patients, which was subtle and subcentimeter in half of the cases, best demonstrated with high-resolution imaging in the coronal plane. In this article, we discuss the correlation between olfactory dysfunction and brain pathology in both TBI and non-TBI settings. We then provide our recommendation for an orbit magnetic resonance imaging (MRI) to evaluate the inferior frontal lobes and olfactory bulbs in patients with unexplained anosmia.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>29635584</pmid><doi>10.1093/milmed/usx178</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Brain Injuries, Traumatic - diagnosis Clinical Competence - standards Decision Making Head injuries Humans Magnetic Resonance Imaging - methods Male Middle Aged Military personnel Neuroimaging Neuroimaging - methods Neuroimaging - trends NMR Nuclear magnetic resonance Olfaction disorders Olfactory Perception - physiology Retrospective Studies Sensory perception Smell Traumatic brain injury |
| title | Olfactory Testing Informs the Decision Process to Obtain Advanced Neuroimaging in Traumatic Brain Injury |
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