电动磨盘致前额叶损伤后运动不能性缄默症：一例报告及弥散张量纤维束成像研究
Akinetic mutism following prefrontal injury by an electrical grinder a case report: A diffusion tensor tractography study.
作者信息
Jang Sung Ho, Kim Seong Ho, Lee Han Do
机构信息
Department of Physical Medicine and Rehabilitation Department of Neurosurgery, College of Medicine, Yeungnam University, Republic of Korea.
出版信息
Medicine (Baltimore). 2018 Feb;97(6):e9845. doi: 10.1097/MD.0000000000009845.
RATIONALE
A 72-year-old male had suffered from head trauma resulting from injury to his frontal area by an electrical grinder while working at his home.
PATIENT CONCERNS
He lost consciousness for approximately 10 minutes and experienced continuous post-traumatic amnesia.
DIAGNOSES
He was diagnosed as traumatic intracerebral hemorrhage in both frontal lobes, intraventricular hemorrhage, and subarachnoid hemorrhage, and underwent decompressive craniectomy and hematoma removal.
INTERVENTIONS
The patient's Glasgow Coma Scale score was 5. At 2 months after onset, when starting rehabilitation, he showed no spontaneous movement or speech; he remained in a lying position all day with no spontaneous activity.
OUTCOMES
On 2-month diffusion tensor tractography, decreased neural connectivity of the caudate nucleus to the medial prefrontal cortex (PFC, Broadmann area [BA]: 10 and 12) and orbitofrontal cortex (BA 11 and 13) was observed in both hemispheres.
LESSONS
Akinetic mutism following prefrontal injury.
原理
一名72岁男性在家工作时，被电动磨盘机伤到额叶，导致头部创伤。
患者情况
他昏迷了约10分钟，并经历了持续性创伤后遗忘。
诊断
他被诊断为双侧额叶创伤性脑出血、脑室内出血和蛛网膜下腔出血，并接受了减压颅骨切除术和血肿清除术。
干预措施
患者的格拉斯哥昏迷量表评分为5分。发病2个月后开始康复治疗时，他没有自主运动或言语；整天躺着，没有自发活动。
结果
在发病2个月时的弥散张量纤维束成像检查中，观察到双侧半球尾状核与内侧前额叶皮质（PFC，布罗德曼区[BA]：10和12）以及眶额皮质（BA 11和13）之间的神经连接减少。
经验教训
前额叶损伤后出现运动不能性缄默症。
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