Jian Xi, Junyu Wang, Jinfang Liu
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, PR China.
Brain Inj. 2009 May;23(5):445-9. doi: 10.1080/02699050902838157.
To explore the pathological mechanism of post-traumatic mutism (PTM) in children.
A retrospective study of 16 children who suffered from severe head injury and developed PTM.
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).
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.
探讨儿童创伤后缄默症（PTM）的病理机制。
对16例重度颅脑损伤并发生PTM的儿童进行回顾性研究。
创伤后昏迷持续2至72天，平均15.5天；创伤后缄默持续2至56天，平均11.94天。昏迷持续时间与缄默持续时间之间存在显著相关性（p<0.001）。单光子发射计算机断层扫描（SPECT）发现所有患者均出现多个持续性脑缺血区域；区域平均数为5.6个。根据缺血区域数量将患者分为三组：第1组，≤4个；第2组，5至6个；第3组，≥7个。第1组和第2组之间缄默持续时间差异不显著，但第3组与其他两组合并后的差异显著（p<0.05）。
大多数PTM发生于弥漫性脑损伤患者。缄默持续时间与脑缺血区域数量及创伤后昏迷持续时间有关。
