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(Stroke. 2009;40:2226.)
© 2009 American Heart Association, Inc.

Research Letters

Anosmia After Coiling of Ruptured Aneurysms

Prevalence, Prognosis, and Risk Factors

A. Stijntje E. Bor, MD; Sophie L. Niemansburg, MSc; Marieke J.H. Wermer, MD, PhD Gabriel J.E. Rinkel, MD

Department of Neurology (A.S.E.B., S.L.N., G.J.E.R.), Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, the Netherlands; and the Department of Neurology (M.J.H.W.), Leiden University Medical Center, the Netherlands.

Correspondence to A. Stijntje. E. Bor, Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Heidelberglaan 100, room G03.228, PO BOX 85500, 3500 GA Utrecht, The Netherlands. E-mail A.S.E.Bor{at}umcutrecht.nl

Background and Purpose— Anosmia occurs frequently in patients with subarachnoid hemorrhage (SAH) from a ruptured aneurysm treated with clipping. We analyzed prevalence, prognosis, and potential risk factors for anosmia after coiling for SAH.

Methods— We interviewed all patients who resumed independent living after SAH treated with coiling between 1997 and 2007. We assessed by means of logistic regression analyses whether risk of anosmia was influenced by site of the ruptured aneurysm, neurological condition on admission, amount of extravasated blood, hydrocephalus, and treatment for hydrocephalus.

Results— Of 197 patients, 35 (18%; 95%CI:12 to 23) experienced anosmia. Anosmia had improved in 23 (66%) of them; in 20 the recovery had been complete after a median period of 6 weeks (SD ±6.5). Intraventricular hemorrhage was a risk factor for anosmia (OR 2.4; 95%CI:1.0 to 5.9). Anterior aneurysm location (OR 1.1; 95%CI:0.5 to 2.3) and high amount of extravasated blood (OR 0.9; 95%CI:0.4 to 2.1) were not related to anosmia.

Conclusions— Anosmia occurs after coiling in 1 of every 6 SAH patients, but has a good prognosis in most patients. The cause of anosmia after coiling for ruptured aneurysms remains elusive; severity of the initial hemorrhage or long lasting hydrocephalus may be contributing factors.

Key Words: intracranial aneurysm • subarachnoid hemorrhage • olfaction disorders • cohort studies • risk factor

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