Visual hallucinations as a manifestation of cerebrovascular disease: a narrative review of the diagnostic approach and neuroanatomical basis
DOI:
https://doi.org/10.70577/m64sm564Keywords:
visual hallucinations; cerebrovascular disease; stroke; neuroanatomy; differential diagnosis; neuroimaging.Abstract
Visual hallucinations are an uncommon neurological manifestation whose etiology includes psychiatric disorders, neurodegenerative diseases, ophthalmologic conditions, and structural lesions of the central nervous system. Among these, cerebrovascular disease is of particular clinical relevance, as visual hallucinations may represent the first sign of involvement of structures responsible for visual processing, facilitating the early diagnosis of potentially treatable vascular events. The aim of this narrative review was to analyze the scientific evidence regarding visual hallucinations as a manifestation of cerebrovascular disease, integrating their neuroanatomical basis, pathophysiological mechanisms, and diagnostic approach. A narrative review of the literature was conducted through searches of biomedical databases, selecting publications related to vascular neurology, neuroanatomy, neuroimaging, and differential diagnosis. The available evidence indicates that visual hallucinations are primarily associated with lesions involving the posterior cerebral artery territory, although they may also occur in thalamic, mesencephalic, and brainstem infarctions. Their pathophysiology involves mechanisms such as cortical release, neuronal deafferentation, cortical hyperexcitability, and disruption of thalamocortical networks. The diagnostic approach requires a comprehensive clinical assessment supported by neuroimaging techniques to distinguish these manifestations from other neurological, ophthalmological, and psychiatric conditions. Early recognition of cerebrovascular-related visual hallucinations facilitates anatomical localization of the lesion, optimizes clinical decision-making, and contributes to the timely diagnosis of a potentially disabling condition.
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Copyright (c) 2026 Gabriel Mayner Tresol, Jimmy Fernando Yaguana Torres, Skarlet Abigail Tacuri Pantaleón, Camila Valentina Suárez Párraga, Andrea Fernanda Gaibor Cerezo (Autor/a)
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