Post-traumatic mutism in children.

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, < or = 4; group 2, 5 approximately 6; group 3, > or = 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.