Case Report of Acquired Stuttering After Soccer-Related Concussion: Functional Magnetic Resonance Imaging as a Prognostic Tool.

BACKGROUND

Acquired stuttering has been reported resulting from various forms of traumatic brain injury. In stuttering patients, there has been an association with higher activity of right frontal operculum activity on functional magnetic resonance imaging (MRI). This report looked to identify any structural lesions in a patient with postconcussive stuttering after a head injury playing soccer.

CASE DESCRIPTION: A 16-year-old girl presented with acquired stuttering after striking the back of her head during a soccer match. She did not lose consciousness. She complained of a mild headache, complained of blurred vision, and was slightly lethargic. The next morning, she was noted to have a significant problem with stuttering. Examination was remarkable for some mild occipital tenderness. Speech was noted to have significant stuttering. She was unable to sing without stuttering. Remaining neurologic examination was normal. Brain computed tomography scan and MRI were normal, with no evidence of any bleeding or contusions. Functional MRI was performed, and no increased activity was seen in the right frontal operculum. The patient was referred for speech therapy. Her symptoms continued for 6 weeks and slowly started to improve and resolved by 9 weeks after her accident. At 6 months, she had no residual speech problems.

CONCLUSIONS

Stuttering can occur after mild to moderate head trauma. Patients with permanent stuttering have been found to have increased activity in the right frontal operculum. If no identifiable lesion can be seen, the stuttering may resolve spontaneously. Functional MRI maybe helpful in differentiating between permanent versus transient stuttering after head trauma.