Abstract
Objective: To explore the pathological mechanism of post-traumatic mutism (PTM) in children.
Methods: A retrospective study of 16 children who suffered from severe head injury and developed PTM.
Results: Post-traumatic coma lasted from 2–72 days, average 15.5 days; while post-traumatic mutism lasted from 2–56 days, average 11.94 days. The correlation between duration of coma and mutism was significant (p < 0.001). SPECT found that multiple persistent ischaemic brain regions occurred in all patients; the mean number of regions was 5.6. The patients were sub-divided into three groups based on the number of ischaemic regions: group 1, ≤ 4; group 2, 5 ∼ 6; group 3, ≥ 7. The duration of mutism did not differ significantly between groups 1 and 2, but the difference between group 3 and the other two groups combined was significant (p < 0.05).
Conclusion: Most PTM occurred in patients with diffuse brain injury. The duration of mutism was related to the number of ischaemic brain regions and the duration of post-traumatic coma.