{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T07:00:32Z","timestamp":1774422032243,"version":"3.50.1"},"reference-count":8,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,6,11]]},"abstract":"<jats:p>We report the case of a 36-year-old woman with a subarachnoid haemorrhage (SAH) caused by a rupture of a right-sided middle cerebral artery aneurysm and subsequent malignant infarction of the right hemisphere leading to a persistent vegetative state and severe spastic tetraparesis with recurrent myocloni. Nine months after disease onset, the patient was transferred to our department for diagnostic and therapeutic re-evaluation. The poor clinical condition could not be explained by the brain lesion caused by the SAH or infarction. Moreover, glucose metabolism was normal in brain regions not affected by SAH and infarction as shown by positron emission tomography with <jats:sup>18<\/jats:sup>F-fluorodeoxyglucose. We terminated baclofen and reduced antiepileptics known to impair vigilance and cognitive functions. However, only after starting amantadine treatment we observed a stunning awakening of the patient fully orientated within days. Our findings warrant trials to investigate amantadine in the treatment of unresponsive wakefulness syndromes due to acute central nervous system diseases.<\/jats:p>","DOI":"10.1136\/bcr-2017-220305","type":"journal-article","created":{"date-parts":[[2017,9,24]],"date-time":"2017-09-24T05:29:39Z","timestamp":1506230979000},"page":"bcr-2017-220305","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Awakening with amantadine from a persistent vegetative state after subarachnoid haemorrhage"],"prefix":"10.1136","volume":"2017","author":[{"given":"Sophie Mirabell","family":"Lehnerer","sequence":"first","affiliation":[{"name":"Department of Experimental Neurology, NeuroCure Clinical Research Center, and Department of Neurology, Charite\u00b4\u2013University Medicine Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Franziska","family":"Scheibe","sequence":"additional","affiliation":[{"name":"Department of Experimental Neurology, NeuroCure Clinical Research Center, and Department of Neurology, Charite\u00b4\u2013University Medicine Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ralph","family":"Buchert","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Charite\u00b4\u2013University Medicine Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Kliesch","sequence":"additional","affiliation":[{"name":"Department of Neuroradiology, Charite\u00b4\u2013University Medicine Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Meisel","sequence":"additional","affiliation":[{"name":"Department of Experimental Neurology, NeuroCure Clinical Research Center, and Department of Neurology, Charite\u00b4\u2013University Medicine Berlin, Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,7,24]]},"reference":[{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1K284"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3654"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2009.03.011"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1102609"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.5","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200208000-00004"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.6","doi-asserted-by":"crossref","first-page":"387","DOI":"10.1097\/HTR.0000000000000027","article-title":"Posttraumatic parkinsonism","volume":"29","author":"Formisano","year":"2014","journal-title":"J Head Trauma Rehabil"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60042-8"},{"key":"2025082707384491000_2017.jul21_1.bcr-2017-220305.8","doi-asserted-by":"crossref","first-page":"187","DOI":"10.3109\/02688697.2013.841845","article-title":"Therapeutic options to enhance Coma arousal after traumatic brain injury: state of the art of current treatments to improve Coma recovery","volume":"28","author":"Cossu","year":"2014","journal-title":"Br J Neurosurg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-220305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:38:52Z","timestamp":1756305532000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-220305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,24]]},"references-count":8,"alternative-id":["10.1136\/bcr-2017-220305"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-220305","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,24]]}}}