Thank-you all for the info. You tend to confirm what I thought, that whilst it is possible to see how this might occur, it does not seem to happen. Thanks again
JP
>>> Adrian Fogarty <[log in to unmask]> 02/22/01 12:26am >>>
> -----Original Message-----
> From:
> Jonathan Marrow
>
> Dear All
> This does ring a bell. I saw a patient who had been involved in a
> moderately violent motor vehicle collision some years ago now. He was not
> dangerously hurt and, to the best of my recollection, had no significant
> head or facial injury. His work required him to choose wines for social
> functions and after the accident he found that he could not
> discriminate as
> he had before. His sense of smell was severely obtunded, though I am not
> sure now if it was completely gone. It got him down quite badly.
>
> I can't end the story with any satisfactory anatomical explanation, I am
> afraid. The effect did not change over two years after the
> injury. Was it
> all psychological? Was there an occult injury to the facial
> skeleton? Can
> a violent jolt injure the olfactory endings directly?
Not sure about whiplash in this respect Jonathan, but it is widely
recognised that concussion can lead to anosmia, and the mechanism is indeed
thought to be related to shearing of the olfactory bundles as they course
through the cribriform plate to reach the olfactory bulbs. By the same token
it is also well recognised that neurosurgical handling of the frontal lobes
can lead to similar injury to the olfactory bundles leading to anosmia. It
would therefore seem plausible that a particularly violent whiplash injury
might lead to a similar phenomenon. Of course in whiplash the head and brain
move largely in unison, unlike in concussion, but presumably if one forcibly
strikes the headrest during the initial cervical hyperextension movement,
then this will effectively lead to a cranio-cerebral shearing injury and
possible subsequent anosmia.
Regards
Adrian Fogarty
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