Visual hallucinations in recovery from cortical blindness: imaging correlates.
OBJECTIVE
To investigate the cerebral metabolic and functional patterns during recovery from cortical blindness.


METHODS
Follow-up study with serial clinical, metabolic, and functional imaging and visual evoked potentials.


METHODS
A 24-year-old woman suffered from cortical blindness after cardiac arrest and recovered over a 6-month period. During recovery, she experienced complex visual hallucinations that could be initiated by visual imagery.


RESULTS
Initially, the regional cerebral metabolic rate of glucose was severely reduced in the visual and parieto-occipital cortex bilaterally but recovered almost completely. Visual hallucinations led to significant increases of the regional cerebral blood flow in the initially severely hypometabolic parieto-occipital and temporo-lateral cortex.


CONCLUSIONS
Recovery of vision was related to normalization of the postlesionally dysfunctional cortex. Visual hallucinations appeared as the clinical correlate of the electrophysiological hyperexcitability of the recovering partially damaged visual cortex.
Wunderlich
G
G
Neurologische Klinik, Heinrich-Heine-Universität, Düsseldorf, Germany. gilbertw@neurologie.uni-duesseldorf.de
Suchan
B
B
Volkmann
J
J
Herzog
H
H
Hömberg
V
V
Seitz
R J
RJ
D000328:Adult; D019575:Blindness, Cortical / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D016887:Cardiopulmonary Resuscitation; D002540:Cerebral Cortex / Q000098:blood supply / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology; D005074:Evoked Potentials, Visual / Q000502:physiology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006212:Hallucinations / Q000209:etiology*; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D020127:Recovery of Function; D014055:Tomography, Emission-Computed; D014793:Visual Cortex / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology
D019788:Fluorodeoxyglucose F18