Mutism After Closed Head Injury

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Abstract
• Prospective study of patients admitted to a hospital for closed head injury showed that nine patients (nearly 3%) became mute for varying periods despite recovery of consciousness and communication through a nonspeech channel. Computed tomography (CT) showed subcortical lesions situated primarily in the putamen and internal capsule of four patients, whereas four of the five patients without subcortical lesions had left-hemisphere cortical injury. The patients without subcortical injury visualized by CT exhibited a longer duration of impaired consciousness consistent with severe diffuse brain injury and they showed more long-term linguistic deficits. We related our findings to recent studies of atypical aphasia after occlusive vascular lesions of the basal ganglia.