Akinetic mutism following prefrontal injury by an electrical grinder a case report: A diffusion tensor tractography study

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Abstract

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.

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