[Visual hallucination associated with anterior cerebral artery occlusion]

The author experienced two cases who showed visual hallucinations after they had had CT-proven cerebral infarctions in the left fronto-medial lobe. Cerebral angiography evidenced the occlusion of the left anterior cerebral artery at the genu portion (case 1) and after branching the frontopolar artery (case 2). Case 1 was a 50 year old national rail way officer who had neither past history of a drug abuse nor that of psychoses. His initial symptom was right hemiparesis predominantly in his lower extremity. Mutism and sympathetic apraxia were also observed. About three months after the onset, he showed psychical excitement due to his curious experience of seeing dogs and snakes in the window and ceiling of his hospital room. A famous professional golf player was also seen. This hallucination lasted about three weeks and never occurred afterwards. Case 2 was a 70 year old housewife who was noticed abnormal by her family because of her mutism of sudden onset. Clumsiness of her extremities was also seen. She had nothing to do with a drug abuse and psychoses. Three days after the onset her mutism turned into talkativeness. She complained of seeing dead persons, who were hanging and coming from the ceiling of her room. Animals and familiar landscapes were also seen. This hallucination lasted about a week. In both cases hallucinations were vivid and colorful. Patients were basically critical for the phenomena although they were initially influenced and excited by them. Temporal and occipital lobes have been thought to bo responsible for the occurrence of organic hallucinations in supratentorial lesions.(ABSTRACT TRUNCATED AT 250 WORDS)