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Anosmia or Loss of Smell from Brain Injury

Comments [24]

Nathan Zasler, MD, FAAPM&R, FAADEP, DAAPM, CBIST, BrainLine

Anosmia or Loss of Smell from Brain Injury
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My friend had a brain hemorrhage from a blow to the head 10 years ago and has completely lost his sense of smell. Apparently, the part of his brain that controls his sense of smell was permanently damaged.

Is it possible that even though the brain does not recognize or register any kind of smell, the effects of that smell still be experienced? For example, even though he can’t smell coffee or lavender, could he still get stimulating effects of the coffee aroma or the relaxation effects of the scent of lavender?

 

Smell loss following traumatic brain injury is often overlooked as doctors tend not bother to ask about or test for loss or change in smell — or taste for that matter. Many times, people with brain injury first report changes in taste when they lose or notice a change in their ability to smell. Typically, complete loss of smell — or what is called anosmia — will be quite noticeable to a person following a traumatic brain injury and may affect numerous aspects of their life. Unfortunately, there is no good treatment cure for post-traumatic anosmia. Typically, if a person doesn’t regain his ability to smell six months after the injury, the loss will likely be permanent.

Because of the complex mechanisms involved in olfaction — a person’s sense of smell — it’s difficult to determine the reason for the loss. Problems with smell loss can result from craniofacial trauma, specifically damage to nasal passage ways, shearing injury of the olfactory nerve, or injury to primary or secondary smell centers in the frontotemporal regions of the brain. There are also other non-traumatic causes for smell impairment including Alzheimer’s disease and smoking, to name just two. This is why it’s important for people with this type of problem to seek out appropriate evaluation by a doctor familiar with post-traumatic smell loss.

If your friend is truly anosmic, that is, he has totally lost his sense of smell, then he would probably not recognize or register any kind of smell since the olfactory nerve is responsible for scent recognition. Therefore, your friend would not benefit from smelling any substance. That said, we don’t have a lot of research on this. Some people have anecdotally described “blind smell” similar to blind sight (a phenomenon in which people who are perceptually blind in a certain area of their visual field demonstrate some response to visual stimuli), and it wouldn’t hurt for your friend to try and experiment with smells.

 

Click here to go to About Ask the Expert.

Nathan D. Zasler, MD Nathan D. Zasler, MD, Nathan Zasler, MD is CEO and medical director for Concussion Care Centre of Virginia, Ltd. as well as CEO and medical director for Tree of Life Services, Inc.  He is board certified in physical medicine and rehabilitation and fellowship trained in brain injury.


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Comments [24]

I had head injury on 23rd Jan 2012 and I lost of my smelling sense. Still I am waiting to come it back. I feel so bad when everyone talks about smell. but still i am waiting.

Apr 9th, 2014 5:13am

I fell backwards down one step and fractured my skull about eighteen months ago.  There is no return of being able to smell, although taste (a much less sophisticated sense) gives me 'sweet, salty, bitter' sensations.  My eyes water when I peel onions, so there's some reflex activity there.

I miss everything; red and white wine taste the same, as do tea and coffee; all flavours and spices are simply bland to me now - everything tastes like oatmeal.  But it's much more than food and drink; I can't smell my children, my dog, burnt food, the scent of the plants, the woods, gasoline, perfume, bleach, vomit, smoke.  Older people often lose the sense of smell, especially those who go on to develop dementia, but there is relatively little understood about the effect of this type of loss.  Obviously, it is not as devastating a loss as hearing or vision would be, but it is sad and life-changing all the same.  I cannot believe that I would be fortunate enough to be amongst the few who do regain it eventually, but I am considering acupuncture, as one article suggests.  You do acclimatize to the new reality over time, but it's a little like seeing in black and white, when you know there are colours everywhere.

Mar 27th, 2014 8:00pm

Two months ago, I woke up and got out of bed to notice that my pillow had about a 6 inch circle of blood on it.  I remember getting drunk; but I don't remember hitting the back of my head.  I must have fell backwards on a hard surface.  I noticed that my smell was absent and my taste was diminished.  I can slightly smell things like cigarette smoke, and a faint smell of vinegar  while putting my nose over the opening of a plastic, one gallon jug.  My taste is about 75 percent absent.  I still crave crave fryed foods and hamburgers.  I now have a weird smell that is always there.  That smell can closely be related to an electrical short or an overloaded electrical circuit.  I do hope my smell comes back.  I am a recovering alcoholic and this might be my wake-up call.  I have not seeked medical attention for my anosmia, nor did I seek medical attention after my head injury.  I have been able to function in every other way.  After doing a small amount of research, I am fine without being evaluated for this condition.  Things could be worse and I am thankful that I am sober again.  I thank God for all the many pleasures that I can still enjoy.

Mar 19th, 2014 11:34am

Besides describing terrible accidents (reading all these concrete- and motorcycle-stories leaves me bewildered and clueless) can anyone here recommend a certain therapy, institution or a specialist? Where did you have a good experience? 
I'm trying to get an overview of different approaches.
I would be specifically interested in surgical treatments and their success-rate.
Thank you and all fingers crossed for your recovery!
 

Mar 11th, 2014 8:46pm

In 1993, I suffered a Traumatic Brain Injury. An 18 year old "man" was obsessed with my 13 year old little sister. He broke into my house in the middle of the night. He brutally murdered my Mom, my brother and tried to kill me. I was shot in the head 3 times. I was the only one out of us three who made it. I was rushed to the hospital via Air Ambulance. When I woke up, I realized a month had passed. I was unable to taste or smell most things. What I could taste or smell was awful. My doctor told me it would come back. It has been well over 20 years and still nothing. I have learned to deal with it. I found this 'disability' to be very frustrating with cooking/eating (not being able to smell or taste turns a person off food), raising 3 children (who are now 20, 16, 12) - especially when they were babies, not being able to smell the beautiful things in life. I have done it so I focus on what I can do. I have tried to remember what things smell and taste like. It has given me the ability to almost taste or smell things. Don't give up - make it work another way.

Feb 25th, 2014 12:05pm

having damaged my brain after a bicycle accident 12 months ago  at the age of 53 in perth oz .i,m recovering slowly after  the injury the loss of  my smell taste and partial hearing has very slightly improved which gives one hope .            being a  skilled chef and having a very highly sensitive sense of smell n taste (especially with my  huge conk). the experience of aromas/smells and odours i now have are never good nor bad just weird from blends of burnt drilled wood to coriander to tiger balm .after analysis and speaking to many neuro's these mental injuries we all have,  it seems/ i think we all have unique and complex injuries to our brains and we all recover differently such like an individuals personality.    obviously after 12 months  i,m more looking at the optimistic and positive side now like losing weight, eating lots of food still, i just have ommitted all the food i used to love but were no good for my body (choc sugars pastrys +), being for some reason more cheerful the bang has shaken up all my neuro endorphins, remembering all those(and not missing) shitty bad smells, cigarette smoke/toilet smells holding my breath  when i was in a  new delhi bog . no more.. no offense mean't ..   good recovery and best of health try to keep smiling to everyone..                        

Jan 2nd, 2014 11:58pm

I lost my sense of smell 10 years ago after falling backwards on ice and bashing the back of my head. I was so concussed I never even thought to see the Dr! I lived alone. 2 weeks later I cricked my neck and saw my osteopath who asked how I had got concussion and whiplash. It later dawned on me I hadn't no sense of smell. Since then my taste has also all but gone. Eventually I had an MRI scan to see if there was any other damage and the Dr confirmed my nerve olfactory nerves were severed and I would never get my smell back. Pretty dismal. - I never smelt my baby. I figure though that there are far worse senses to lose. I enjoy chocolate and texture foods and I think much of what I taste is my memory knowing what to expect - and so it is getting worse as I get older. It's useful at times, working with teenagers! 

Nov 28th, 2013 5:50pm

I was in a abusive marriage, my ex husband hit me with his car and I hit the concrete floor pretty hard. I woke up in the hospital with lost of taste and smell, this all happened January 22,2012 and I will be going on 2 years now still not being able to taste or smell. It's frustrating but I pray for it to come back. I am 25 years old, female. I understand when you say it's hurtful when people say 'oh it smells good, smell it' I feel hurt not being able to smell roses. I love roses! Or 'you have to taste this, it taste so good' I am still standing strong! I have hope it will all come back.

Nov 26th, 2013 8:48pm

Don't give up! I had TBI 3 years ago. First year I couldn't smell or taste anything. Then, slowly it started coming back. It is still not as before TBI and sometimes it works, sometimes it doesn't... but I know it will come back...

Oct 12th, 2013 12:32pm

I'd like to update my comment of 5/31. The "bad smell" seems to be diminishing, as the background smell is much less noticeable now. Coffee and chocolate are still intolerable. I am still adjusting and have lost about 20-25 lbs since my sense of smell was lost. I needed to lose some but really don't want to get much thinner. I used to love bread, but now it is just taseless mush, so I have given it up. Alcohol has absolutely no allure for me now, and besides, there is no flavor to it. I have drunk the occasional beer to be social, but a Bud Light tastes the same as a craft beer--just cold and wet. I used to be in a wine club, but I dropped out as it makes no sense. I like things I can taste with my tongue--sweet, sour, salty. Most fruits are really delightful--cherries, honeydew, peaches, blueberries--but strawberries suck. All in all, I am still adjusting and still hope for improvement as there seems to be some evolution of the problem. I am encouraged by the rare stories of late improvement, but I don't hold out a great deal of hope. And if things don't change, I don't really see it as a tragedy. The funny thing is, as much as I loved coffee, chocolate and the occasional cocktail, I really don't miss them. The desire is simply not there.

Sep 22nd, 2013 1:46pm

I too, since third concussion have minimal sense of smell and taste, thank God it's not completely gone. I am scheduled for an MRI to see if I have completely snapped the thing that's responsible for sense of smell and taste. I have a lot more questions. It's been over a year since the last head injury. I'm having other issues too, it knocked the period out of me and put me into early menopause;-( so I recently had a biopsy due to thickened lining of my uterus. Gyne is saying I will have to have Dand C to fix lining. So lots of problems as a result of head injury, ....

Sep 1st, 2013 12:41am

This March I suffered head trauma from hitting the back of my head very hard. I spent 4 days in the hospital and a few weeks after I was released I noticed I couldn't smell anything. It has been almost six months since the accident and I'm starting to notice scents but almost everything smells the same. The weird part is I can taste everything. What should I do or be doing.

Aug 30th, 2013 3:12am

my father also had an motorcycle accident last month July 2013 and now he suffering in taste and sense of smell,,hope you can help me,,,absent of sense of smell and taste is the problem of my father

Aug 23rd, 2013 11:34am

I fractured my skull and had a brain haemorrhage in 2006 and I realised I had lost my sense of smell:( but my taste has always been A OK (touch wood lol) I have been smoking pretty much since the accident but I have recently over the past year or two been getting strong wiffs:) the more I think about smells (if you don't use it you loose it! even for those who are lucky enough not to have had a severe head trauma!) the more I seem to be getting it back:D ever so slightly mind but hey ho:D the best things are worth waiting for:D:D due to this I am stopping smoking:D and here are a few things that I am going to give a go:D hopefully they can help me and everyone to:) I am going to eat and smell as much of these goodies as I can:D peppermint and cinnamon improve concentration, and decrease irritability, lemon and coffee promote clear thinking! and height concentration in general. NO DAIRY!!:( it will be hard but worth a try as it cause excess mucus! coconut milk I am going to try in my porridge:D good for serotonin levels to:)eating foods high in zinc; oysters, lentils, sunflower seeds, pecans:) (have to be whole nuts and seeds!!) get zinc supplement at least 7mg a day:) smell is heightened after exercise:D clears your tubes out:D and stay away from things that smell bad:S they are hard to know what but i have noticed especially that when i come back to the city it has a bad smell - country air does you good:) carry vanilla and lemon, short and shallow sniffs of the food your body id craving when you go to the market:D what your body craves will smell more yummy:)

Jul 29th, 2013 8:29pm

My father had head injury 2 and half months ago. He recovered well from injury except that he can\'t taste and smell things. Doctors said he may or may not get taste and smell back. He is still not aware of the fact that he may not get taste and smell at all. Is there any medication which can help him to get his taste and smell back? I wish he gets these at the earliest.

Jul 22nd, 2013 2:10pm

I lost my sense of smell completely 12 years ago after a concussion caused by hitting the back of my head on a concrete floor. The hardest part was in the first year when I was trying to understand what had happened and what I could do about it. It was terribly frustrating not being able to smell when I still had the associations. At some point I realised that there was nothing I could do and I had to accept it. From that point, it became much easier to live with. I rationalised that as my only health complaint, it's really not that bad. I think that although my sense of smell is still completely absent, perhaps my taste buds have become more sensitised. I have since heard of someone whose sense of smell returned after 20 years. So perhaps there is hope after all...

Jul 1st, 2013 5:30pm

2.5 years after suffering a TBI from a no-helmet motorcycle wreck, I'm starting to get my sense of smell back!! Don't give up hope. I can smell very strong unique scents like coffee and garlic and onions sauteeing. I do use waaay more hot sauce on my food since the wreck tho, Sriracha on everything. I still can't smell stinky smells yet, so I guess I'm lucky.

Jun 12th, 2013 5:59pm

I had a concussion 4 months ago. At 2 weeks I realized my sense of smell was greatly diminished. Three weeks after that I started to get the "bad smell." That's what I call the burnt or somewhat chemical smell that I have all the time. It is worsened by many normally pleasant odors.I can still smell vinegar and an alcohol swab, but that's about it. MRI and CT both normal. I had 8 acupunture treatments without any change. Many formerly pleasant foods are now intolerable--chocolate, coffee, peanut butter, mayonaise, ketchup and many more. I am still adjusting, eating bland foods--tortillas, turkey, provolone. Tomatoes and many fruits are good. The fall (hitting the back of my head) was truly life-changing. I haven't completely given up hope that I will recover, but there has been no change for 2 months. It sounds like I shouldn't waste any more time or money seeing more docs.

May 31st, 2013 4:57pm

Hello fellow brain damaged I fell from a 4 story window and am back to normal besides the psysical part . I have some \"plasebo\" blinks of smell in some situations and is enjoying life to the fullest including eating and drinking things. I can taste the basics such as salt,sweet,sour aso. Therefore there is no problem because there are such much food within those parameters incl. texture, fill. You just have to try everything. My favorites are mexican food, liqerise, high presentage beer, gingerbeer soda, icecream, sweet wine and halapeno peppers.

May 24th, 2013 7:49pm

I had a fall 9 weeks ago and first hit my head forward and then went backwards and hit on a concrete floor. I have no recollection of any of the accident. I was in ICU for 5 days, and although I am getting along a lot better, I still have no taste or sense of smell. I have no appetite and just eat to keep up my strength. I had all the tests, CT, MRI, EEG. My EEG came back as a small abnormality and the Dr. will give me the details when I go back to him next month. I have balance issues and headaches. I am getting along a lot better, but just wish I could enjoy food again.

May 23rd, 2013 9:58am

Had an motorcycle accident on 12 March had no CT scan on the day have no taste or sense of smell ,really scared, not to be able to taste food or smell the perfume of a women scares me, Life is very dull. I feel trapped in a bubble along with others injuries broken bones etc. But as my doctor said still alive, but without my smell and taste i may as well be dead....

Apr 11th, 2013 6:01pm

My main issue 4 years later is the zero function in my smell and my taste is awkward at best. Basically my taste buds are effective but nothing else concerned with smell so too many flavours in one pallete cause me to to taste nothing, so with spicy foods all i get is "Hot" unless it is mild. Main issue though is my complete loss of people skills. I used to be a people person who could naturally chat to anyone anywhere anytime but now i get all nervous when i'm chatting to people i don't know or havent seen in ages or am talking to for purposes etc. It really is an understated condition that hospitals/doctors should prioritise better.

Sep 29th, 2012 5:11pm

thanks for your information, I am from Halabja-Iraq, and my small brother suffered from head injury because of motor accident about 4 months ago,and he have not smell sense now,I wish and I ask God to regive him the grace of smell, Thanks

Sep 3rd, 2012 2:56pm

Having Anosmia seems to be related to sense of taste also. I am 14 years post injury and my sense of smell is not totally gone, but it is picky. For example, I can smell vanilla, and most other smells, but they have to be very strong. My sense of taste is also dulled.

Jan 31st, 2011 11:05am


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