Management of severe behavioural dyscontrol following subarachnoid haemorrhage

Intracranial aneurysms commonly rupture into the subarachnoid space, resulting in severe impairments in cognitive and behavioural functioning. We present a case involving a subarachnoid haemorrhage, secondary to the rupture of a right middle cerebral artery aneurysm, which resulted in an unusual neurobehavioural syndrome. The patient developed severe behavioural dys-control, characterised by repetitive involuntary oral exhalations, involuntary vocalisations and oral-facial dyskinesia. Despite the persistent manifestation of these behaviours at 3 months post-onset, combined with other cognitive and motor disorders typical of right hemisphere lesions, the patient was able to learn to inhibit these involuntary behaviours through training in the implementation of a behaviour that was incompatible with the emission of such behaviours.