SHORT-LASTING SUDDEN EPISODES OF GREEN COLOURATION OF THE WHOLE VISUAL FIELD, EVEN PERSISTENT SIX MONTHS AFTER A CRANIAL TRAUMA.

Renato COCCHI, a neurologist and a medical psychologist.

 

Summary.

In a right-handed woman of 59 years, with a university degree, following an occipital cranial trauma without loss of conscience, short-lasting episodes of green colouration of the whole visual field appeared, that are repeating even six months after from the trauma. The phenomenon is of ictal type, and it has links with the stress. This had attributed to a trouble of half-brain dominance in an exact zone of the occipital cortex, where is the elaborating of the colour stimuli and/or their opposites have their processing. An interpretation as "epileptic equivalents" has done.

Key words: Red, green, opposite colours, cranial trauma, stress, PTSD, green colouration, visual field, ictal-type phenomenon, GABA, glutamate, epilepsy.

 

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Clinical cases

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As a researcher hopes it occurs, it happened to me. To have started to deal with an investigation field, the relationship between the colour Red and the colour Green in half-brains. Then I shaw arriving, unexpected, the clinical case that confirmed the correctness of some hypotheses.

I would wish not that one could think I am attributing to myself nonexistent retroactive worth. In the first page of this site there is a drawing of two half-brains, one red to the left, and the green one to the right. The page has been posted on Internet on 28 January 2000. First I have seen this case on March 2004, eight days later after a cranial trauma. For what I could check, it doesn't exist in literature the description of a similar case.

 

The case.

F, of 59 years, a psychologist and an expert graphologist of the courts. Married, with two sons by now adults.

The patient had an incident on 14 March 2004, about 2pm, because the house elevator did not come perfectly to the floor level. Since she did not mind the stair and did not foresee it, she beat the occipital region of the skull, the right knee, and even the right shoulder, elbow and wrist. At the emergency room of the town hospital the physicians described her as collaborative, conscious but slowed, well oriented as for the time and the space. Her eyes' pupils were isochoric, isocyclic, both reacting to the light. No other focal neurologic sign reported. They attributed her a score of 15 at the Glasgow scale. She affirmed there to have a headache.

CAT of the brain and CAT of the cervical rachis resulted negatively. Nothing was in relief in the right wrist and in the right knees.

Being Sent to the neurosurgery unit for observation, in her enter she was sleepy and with head ache. A further brain CAT, with a contrast medium, resulted negatively. Even another CAT to the cervical rachis resulted negatively.

She left the hospital on 16.03.2004, with improved head ache. During her staying there she did not get an EEG examination.

 

22 March 2004. A neuropsychiatric examination eight days after skull trauma, in outpatients'. It results that after the casualty, while she was resting to bed home, she had a conscience loss lasting 3-5 minutes. This fact drove her familiars to bring her to the emergency room, and from here to the neurosurgery unit, where she rested three days with drowsiness, asthenia and head ache. She reported that the mornings after the admission she had the feeling of green field of vision, either with her eye closed or just open.

At home, during the last five days, she noticed problems of linguistic confusion (First she did not understand what speaking meant), and a continued tendency to fall asleep. Nuchal head ache persisted, not due to cervical arthrosis, more intense towards evening. She does difficulties to maintain as structured the temporal coordinates. Now she is feeling a little dulled, with short-term memory's troubles, difficulty to recall the usual telephone numbers, well remembered before the trauma. Unjustified feelings of fear occur.

Now she is easy to cry for no reason. Bulimic hunger runs, both for sweet things and salted ones. Her bowel function did not change, but she needs to urinate very frequently, being the maximum interval of two hours. Dyslalias increased. Now she partly lost her ability to write with the computer but no dyslexic troubles occurred. Currently she has a deficit of concentration. She has the impression of having her head stuffed with wadding ("full of cotton wool "). She affirms of having got a hearing decrease [?]. Moreover, she said of having lost her ability, always had, to gather immediately the "critical point". While she was a very active woman, now has become abulic. No emergency of bad thoughts or inexplicable bad feelings referred.

I asked at once an EEG examination, performed on 01 April 2004, which conclusion were "light bioelectric asynchronous bitemporal alterations, without any specific significance".

To the end I diagnosed PTSD, and I prescribed an antidepressant and antistress drug therapy, which lasted for two months.

04 September 2004: The second neurologic checkup.

She woke up the day after in the morning in the neurosurgery unit, in spite of being affirmed that she was alert, during the transport to the hospital. She does not remember it, like all what happened from the trauma in then [probable foregoing amnesia]. When she had her eyes open, she noticed a sectorial vision ( she was seeing only in front of her, with a very reduced angle of vision) and with a whole general tonality. She reported this fact to the department physicians, who did not make anything of this symptom.

Currently she still has:

- The green vision, lasting several seconds, mainly after having observed of something red, more to diurnal light that to artificial light (A symptom already reported in the hospital). It occurs with nearly daily frequency, also several times in a day, mainly after prolonged attention (measurement of the graphemes, pressing elaboration of writing a judicial examination, observation to the microscope) and generic tiredness.

- Asthenia;

- A headache, starting from the nuchal region with diffusion till the frontal, orbital and temporal areas, with feeling of heat rash too.

- Memory difficulty in the mental operation of choosing within the lexicon ( difficulty to find at once the right word).

- Contemporary oversweating in the zone under the nose, in the armpits, and in the hands'palms.

- Impelling need of emptying the bladder.

- Fits of dizziness, with light disbandments (already reported in the hospital).

- Hyperacusia and discomfort when several persons speak together (already reported in the hospital);

- Feeling of a bitter and dry mouth.

- Tactile feeling of rough, even when she is touching a smooth surface.

- Visual feeling of rocking of the ground, which doesn't correspond to the tactile and kinaesthetic information during walking (already reported in the hospital).

The objective neurologic examination did not show anything of remarkable.

 

Discussion.

The outcomes of the cranial trauma are creditable to two separate phenomena.

The near totality of the symptoms reported is due to the PTSD, with memory troubles, headache, vagal and parasympathicotonic reactions, perception troubles by the hearing, the taste, the touch, and the sense of the equilibrium.

Such troubles are still present about six months after the trauma, and they reappear or they are increased exactly in conditions of physical or mental stress, mainly during the professional activity.

The appearance of the "green vision" has a different origin, which can have a link to an episodic inversion of half-brain dominance, at least in the visual cortex.

To production of this symptom competes:

- the primarily occipital trauma, and then in the areas elaborating the visual perceptions (visual cortex);

- one inducing stimulus (often an object of red colour that, in the opposite half-brain is eleborated with the complementary colour, the opposite one, that is the green, but even the stress in general);

- a missing suppression of the opposite engram (the green colour) that becomes prominent and "colours", for projection, the whole visual perceptive field.

This eventuality, differently from the PTSD, is very few known. On fact perhaps I am the only ne who currently have personal research, published, from at least 10 years (see: <www.reversebrain.net>.

Red and green are two complementary colours, opposite even in the graphic scheme of the primary colours and they first compounds. In the brain, on the contemporary presence of the opposite, in relationship to every perceptive stimulus, it exists a famous neuropsychological experiment never explained in satisfactory way.

If a person intensely watches at a red surface for some minutes, then moves at once the look on a white surface, for a fraction of a second he sees the green colour ( the green is the complementary that is to say the opposite of the red).

If we assume the point of view of the contemporary presence of the opposite as true, we may suppose that the dominant half-brain sees correctly the red.

The not dominant half-brain would perceive the red stimulus as green, but this phenomenon habitually is cancelled. If we move our eyes on the white (which corresponds to no colour), the dominant half-brain adapts at once.

That not dominant one, which is slow er in the elaboration of the stimuli, lets us perceiving for a fraction of a second its residual image (the colour green). This becomes as belonging to the secondary surface, the white one, while it is still the product of the opposite of the stimulus due to the colour of the red surface (Cocchi, 1994).

Incidentally, I wish I remember that already the Greek pre-Christian philosophy with Anaximander of Miletus and mainly Heraclitus of Ephesus, individualized the problem of the opposite. (Di Luciano, 2003).

Has this behaviour of opposition between the two half-brains some experimental or psychopathologic base, which can confirm it?

The starting point can offer by the neurology. In subjects who had brain insults, often in the ictus form, but even as results of accidental traumas or neurosurgical operations, mirror actions can appear: Mirror writing and/or mirror reading (Critchley 1928 and 1953; Paradowski and Ginzburg, 1971; Streifler and Hofman, 1976; Fisher, Liberman and Shankweiler, 1978; Heilman, Howell, Valenstein and she/he/it/you rotates, 1980; Feinberg and Jones, 1985). Mirror speaking too, the first case of which, following neurosurgery of the brain, was described by Cocchi, 1986.

We are dealing with persons who did never show similar features, before the brain insult. An explanation was given, moreover supported even by experimental data in the animal (Orton, 1928, Noble, 1968, Bradshaw, Nettleton and Patterson, 1973 ). "Perceptive stimuli (usually visual ones) produce contemporarily, in the two half-brains, an engram and its opposite " but the opposite is normally cancelled. In particular conditions, this mechanism of suppression becomes inhibited, for which the opposite may appear with a mirror image, the phenomenon mostly known.

Not only writing, or reading and speaking can get a mirror behaviour, but even the manipulation of objects can be made in the opposite way (Feinberg and Jones, 1985). There is not any reason to believe, then, that the phenomenon is specific of the visual perception.

Feinberg and Jones, 1985, suggested that the right-left orientation is not a unitary characteristic, and it may have links to a differential activation of the half-brains, as for acting motor tasks or other tasks. (Cocchi, 1994).

The very emotional subjects (who often coincide with the "neurotic" persons) can have a hyperfunction of areas or structures or functions of the not dominant half-brain. Otherwise they can have an inhibition of the dominant half-brain, in particular on the suppression mechanism of the opposite engram.

To this intention I report here a test I habitually use. If we ask very emotional persons to answer at once, without thinking on, to this question ( Which is the opposite of the colour Red?), not fewer of them answer: Green. When we ask them to explain the reason of this response, they do not know why they said it. True depressed people reply usually: Black (that is instead the opposite of white )(Cocchi, 1994).

The application of this simple test in two groups of Ss brought the results here summarized.

A group of heroin and cocaine addicts (43 Ss) presented highly significant statistic prevalence (p = .0009) of the answer "Green" to the test "Which is the opposite of the colour Red?" as compared to a group of normal persons (61 Ss).

This result confirms that this abuse matters, like the alcohol, can act on the dominant half-brain at least for reducing the suppression mechanism that avoids the clear emergency of the opposite engram of the not-dominant half-brain during any perception (Cocchi, 2002).

The analysis of the answers to the test "test "Which is the opposite of the colour Red?" given by 325 Ss seen in an outpatient's clinic between 1992 and 2002, found 148 opposite answers (45.54%). Of them, 68/148 (45.94%) had the answer of Green (the opposite of the colour Red) and 80/148 (54.06%) with the answer of White (the opposite of colour Black, habitually answered by depressed people).

I did not find again statistically meaningful differences as for gender, while the answer of White came out in a higher statistically significant age. As for the first consultation, I did not observe statistically meaningful differences as for gender and motivation. The same did happen for symptoms or secondarily remarkable particulars driving to the final diagnosis, or other information.

For what concerns the investigation on the opposite answers, some opposite behaviour or feelings were found in the 50% of those people that answered White, but even in several who answered Green. In six subjects out of the 80 who answered White, I could not discover opposite behaviour or feelings, which denies a total correlation between the answer White and opposite behaviour or feelings (Cocchi, 2003).

In this patient I may try an aetiological explanation. The cranial trauma was in her occipital zone. The phenomenon is of visual type, then with a link with the occipital cortex. The phenomenon is of ictal type, it happened even with eyes shut, for which it is possible that in the occipital cortex there is bioelectrical instability.

If this instability is to the left side, it would act by temporarily inhibiting the suppression mechanism of the opposite engram, for which the occipital cortex of the right half-brain would have a temporary relative prevalence.

 If instead it is in the right side, the bioelectrical instability elicits an excitation that overcomes temporarily the suppressive mechanism of the opposite engram, with temporary absolute prevalence. It is not possible to detect which of the two half-brains alters for first.

A causal event remembered by the patient is the relationship with the stress.

As a such, it could act by reducing the type A GABAergic inhibition, with contemporary increasing of the type B GABAergic inhibition, retroactive inhibition of the the GAD ( decarboxylase of the glutamic acid) activity and reduction of the transformation of the glutamate into GABA (Cocchi, Patrucco, Zerbi, 1987 ). The relationship between glutamate and GABA is primarily involved in epilepsy, which has the stress as switching factor. The phenomenon reported by patient could be an "epileptic equivalent".

Finally it is to remember the "bewilder" assertion of the patient, who says that this phenomenon decreases with the artificial light. At once one thinks about the frequency of the alternate electric power in Italy, that is 50 Hz per second. Could have a role the fifty episodes of lighting and turning off every second, not visible by the naked eye for the flicker fusion? It is difficult to go over this first relationship, if it had a maining.

 

Conclusion.

Following an occipital cranial trauma, wery short episodes of green coloration of the whole field of vision appeared, which continue to repeated after 6 months from the trauma. The phenomenon, that is a ictal type, and linked to the stress, was attributed to a trouble of half-brain dominance in an exact zone of the occipital cortex, where the colour stimuli and/or the thei opposite are eleborated. The more probable interpretation is that of a " epileptic equivalent ".

 

References.

Bradshaw J.L., Nettleton N.C., Patterson K.: Identification of mirror-reversed and non-reversed profiles in same and opposite visual fields. J. Exp. Psychol. 1973, 99: 42-48.

Cocchi R.: Defective hemispheric dominance and cognitive behaviour: Speculative considerations. lt. J. lntellect. lmpair. 1994, 7: 19-27. (testo italiano in <www.reversebrain.net/Domin1-it.htm>

Cocchi R, Il test "Dimmi il contrario del Rosso" in tossicodipendenti e in persone normali. Gennaio 2002, in < www.reversebrain.net/domin5-it.htm>

Cocchi R. Il test "Qual è il contrario del colore Rosso" in 325 pazienti ambulatoriali. Gennaio 2003, in < www.reversebrain.net/domin11-it.htm>

Cocchi R., Patrucco M., Zerbi F.: Presupposti razionali per l'aggiunta di una benzodiazepina alle forme epilettiche non controllate in monoterapia. Riv. Neurobiologia 1987; 33/1: 33-48.

Cocchi R., Pola A., Sellerini M., Tosca P., Zerbi F.: Mirror speaking after neurosurgery, Case history. Acta Neurol. Belg. 1986, 86: 224-232.

Critchley, M. Mirror-writing, Kegan Paul, Trench and Trubner. London: 1928,

Critchley M.The parietal lobes. Hafner Press. London, 1953.

Di Luciano A. (coordinatrice) Filosofia. Vol. I. A-Lib. Le Garzantine, Garzanti Libri, Milano 2003.

Feinberg T., Jones G.: Object reversal after parietal lobe infarction - A case report. Cortex 1985: 21: 261-271.

Fischer, F., Liberman, l., Shankweiler, D. Reading reversals and developmental dyslexia: A further study. Cortex, 14, 496 - 510, 1978.

Heilman KM, Howell G, Valenstein E, Rothi L. Mirror-reading and writing in association with right-left spatial disorientation. J Neurol Neurosurg Psychiatry. 1980, 43: 774-480.

Noble J.: Paradoxical interocular transfer of mirror-image discriminations in the optic chiasm sectioned monkeys. Brain Res. 1968, 10: 127-151.

Orton S.T.: Specific reading disability - Strephosymbolia. JAMA 1928, 90: 1095-1099.

Paradowski W, Ginzburg M. Mirror writing and hemiplegia. Percept Mot Skills. 1971, 32: 617-618.

Streifler M, Hofman S. Sinistrad mirror writing and reading after brain concussion in a bi-systemic (oriento-occidental) polyglot. Cortex. 1976, 12: 356-364.

 

Posted on Internet on 24 November 2004. Copyright by Renato Cocchi, 2004.

 

Author's address: dr Renato COCCHI, via Rabbeno, 3

42100 Reggio Emilia (Italy).

renatococchi@libero.it

 

Testo in italiano

Clinical cases

Theoretical and research bases.

 

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