Visual Hallucinations: More Diagnoses

Andrew L. Carney, MD
JAMA. 1987;257(15):2035-2036. doi:10.1001/jama.1987.03390150051029.
Text Size: A A A
Published online

To the Editor.—  In the discussion of visual disorientation of short duration in a patient with right-sided hemiplegia and hemianopsia,1 consideration of hemodynamics at the level of the circle of Willis was omitted. If the patient had occlusion of the left internal carotid artery with a patent left posterior communicating artery, transient occipital lobe ischemia may have been produced by a transient reduction of blood flow in the dominant vertebral artery. This may have been due either to mechanical obstruction of the vertebral artery (eg, as a function of head position) or to a reduction in cardiac output (eg, as a result of the upright position, Valsalva's maneuver, or cardiac dysrhythmia).If the internal carotid artery is occluded and if vertebral angiography shows filling of both the anterior and posterior circulation, brain ischemia with functional impairment is common. Blood flow in the vertebral artery can be maximized by a


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.