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BACKGROUND

Aneurysmal subarachnoid haemorrhage (aSAH) is associated with high morbidity and mortality and is often complicated by rebleeding, hydrocephalus, infection and secondary brain injury.

CASE PRESENTATION: We present a case of a previously healthy man in his thirties who suffered a ruptured anterior communicating artery aneurysm with secondary complications. Brain imaging revealed severe injury to the corpus callosum and cingulate gyrus. He developed akinetic mutism, characterised by severely reduced initiative and an inability to communicate his needs, resulting in complete dependence.

INTERPRETATION: This case highlights the diagnostic challenges in patients with minimal responsiveness, the importance of individualised and sustained rehabilitation, and the potential role of pharmacological treatment with amantadine. While the observed improvement may reflect cumulative rehabilitation effects or spontaneous recovery, the case suggests that selected patients may benefit from pharmacological intervention. Further research is needed to clarify the efficacy and safety of amantadine following non-traumatic brain injury.