Brain Single Photon Emission Computed Tomography in Anosmic Subjects after Closed Head Trauma
Anosmia following head trauma is relatively common and in many cases is persistent and irreversible. The ability to objectively measure such a decline in smelling, for both clinical and medicolegal goals, is very important. The aim of this study was to find results of brain Single Photon Emission Computed Tomography (SPECT) in anosmic subjects after closed head trauma. This case-control cross sectional study was conducted in a tertiary referral University Hospital. The brain perfusion state of nineteen anosmic patients and thirteen normal controls was evaluated by means of the SPECT with 99mtc- ECD infusion- before and after olfactory stimulation. The orbitofrontal lobe of the brain was assumed as the region of interest and changes in perfusion of this area before and after the stimulations were compared in two groups. The mean of brain perfusion in controls before and after the stimulation was 8.26% ± 0.19% and 9.89% ± 0.54%, respectively (P < 0.0001). Among patients group, these quantities were 7.97% ± 1.05% and 8.49% ± 1.5%, respectively (P < 0.004). The difference between all the measures in cases and controls were statistically significant (P < 0.0001). There were no differences in age and sex between two groups. The brain SPECT is an objective technique suitable for evaluating anosmia following the head trauma and it may be used with other diagnostic modalities.
Varney NR, Bushnell D. NeuroSPECT findings in patients with posttraumatic impaired smell: a quantitative analysis. Head Trauma Rehabil 1998;13(3):63-72.
Miani C, Bracale AM, Moreschi C, Codarini M, Ortolani F. Post-traumatic anosmia: description of a clinical case, proposal of a standardized protocol and medico-legal comments. Acta Otorhinolaryngol Ital 2002;22(3):142-9.
Miwa T, Furukawa M, Tsukatani T, Costanzo RM, DiNardo LJ, Reiter ER. Impact of olfactory impairment on quality of life and disability. Arch Otolaryngol Head Neck Surg 2001;127(5):497-503.
Jacobi G, Ritz A, Emrich R. Cranial nerve damage after paediatric head trauma: a long-term follow-up study of 741 cases. Acta Paediatr Hung 1986;27(3):173-87.
Zusho H. Posttraumatic anosmia. Arch Otolaryngol 1982;108(2):90-2.
Biacabe B, Norès JM, Bonfils P. Description and analysis of olfactory disorders after head trauma. Review of the literature. Rev Neurol (Paris) 2000;156(5):451-7.
Hendriks AP. Olfactory dysfunction. Rhinologyn1988;26(4):229-51.
Doty RL, Yousem DM, Pham LT, Kreshak AA, Geckle R,= Lee WW. Olfactory dysfunction in patients with head trauma. Arch Neurol 1997;54(9):1131-40.
Cain WS, Gent J, Catalanotto FA, Goodspeed RB. Clinical evaluation of olfaction. Am J Otolaryngol 1983;4(4):252-6.
Eftekhari M, Assadi M, Kazemi M, Saghari M, Fard Esfahani A, Fallahi Sichani B, et al. A preliminary study of neuroSPECT evaluation of patients with post-traumatic smell impairment. BMC Nucl Med 2005;5:6.
Di Nardo W, Di Girolamo S, Galli A, Meduri G, Paludetti G, De Rossi G. Olfactory function evaluated by SPECT. Am J Rhinol 2000;14(1):57-61.
Savic I. Imaging of brain activation by odorants in humans. Curr Opin Neurobiol 2002;12(4):455-61.
Varney NR, Pinkston JB, Wu JC. Quantitative PET findings in patients with posttraumatic anosmia. J Head Trauma Rehabil 2001;16(3):253-9.
Eftekhari M, Assadi M, Kazemi M, Saghari M, Mojtahedi A, Fard-Esfahani A, et al. Brain perfusion single photonemission computed tomography findings in patients with posttraumatic anosmia and comparison with radiological imaging. Am J Rhinol 2006;20(6):577-81.
Mann NM, Vento JA. A study comparing SPECT and MRI in patients with anosmia after traumatic brain injury. Clin Nucl Med 2006;31(8):458-62.
Warwick JM. Imaging of brain function using SPECT. Metab Brain Dis 2004;19(1-2):113-23.
Catafau AM. Brain SPECT in clinical practice. Part I: perfusion. J Nucl Med 2001;42(2):259-71.
Furtak J, Chmielowski K, Podgórski JK, Skrzyński S, Kadłubowski A, Małowidzka-Serwińska M. Cerebral blood flow changes after mild head trauma imaging with SPECT HMPAO. Preliminary report. Neurol Neurochir Pol 1995;29(3):401-7.
Masdeu JC, Abdel-Dayem H, Van Heertum RL. Head trauma: use of SPECT. J Neuroimaging 1995;5 Suppl 1:S53-7.
Abdel-Dayem HM, Abu-Judeh H, Kumar M, Atay S, Naddaf S, El-Zeftawy H, et al. SPECT brain perfusion abnormalities in mild or moderate traumatic brain injury. Clin Nucl Med 1998;23(5):309-17.
Lyczak P, Lass P, Sygitowicz M, Stepień-Koćmiel E, Mierzejewska E, Bandurski T, et al. Brain perfusion changes after head trauma assessed by cerebral SPECT with aminophylline test. Neurol Neurochir Pol 1998;32(5):1091-8.