Anosmia after coiling of ruptured aneurysms: prevalence, prognosis, and risk factors.
OBJECTIVE
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.
A Stijntje E
AS
Bor
Sophie L
SL
Niemansburg
Marieke J H
MJ
Wermer
Gabriel J E
GJ
Rinkel
D000367:Age Factors; D000368:Aged; D017542:Aneurysm, Ruptured / Q000523:psychology* / Q000601:surgery*; D002340:Carotid Artery Diseases / Q000473:pathology; D002533:Cerebral Angiography; D002539:Cerebral Arterial Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D006849:Hydrocephalus / Q000150:complications / Q000628:therapy; D002532:Intracranial Aneurysm / Q000523:psychology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures; D000857:Olfaction Disorders / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology*; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology*; D011379:Prognosis; D012307:Risk Factors; D013345:Subarachnoid Hemorrhage / Q000150:complications; D013525:Surgical Instruments; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed