A 60-Year-Old Man Comes to the Office Due to Difficulties

A 60-year-old man comes to the office due to difficulties in tasting food.  He says, "All food now tastes bland," and he is unable to enjoy different flavors during meals.  Two months ago, the patient had a traumatic brain injury after a head-on motor vehicle collision.  He was in a coma for several days and, after regaining consciousness, began having severe headaches and impaired taste.  The headaches have improved, but he continues to have difficulty tasting food.  The patient has no visual concerns, slurred speech, trouble swallowing, vertigo, or extremity weakness or numbness.  He is a truck driver and has a history of heavy tobacco use for many years.  Vital signs are within normal limits.  Physical examination shows no focal motor deficits.  Which of the following is the most likely cause of this patient's current symptoms?

A) Anterior temporal lobe contusion
B) Avulsion of olfactory nerve rootlets
C) Ischemic stroke of the dorsolateral medulla
D) Lingual nerve injury
E) Sphenoid bone fracture

Correct Answer:

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