Authors of this case report describe a 72-year-old man with Parkinson’s disease whose longstanding visual hallucinations disappeared immediately after he experienced a right occipitoparietal intracerebral hemorrhage. Before the hemorrhage, he had developed prominent psychotic symptoms, including seeing people in his home and misidentifying his wife. Brain imaging showed a subcortical hemorrhage in the right occipitoparietal region. Although he was treated conservatively and later improved neurologically, the most striking change was the complete resolution of his visual hallucinations. Follow-up imaging three months later showed that the remaining lesion was largely confined to the right precuneus. During that period, he continued to be free of visual hallucinations, even after other visual and spatial deficits had resolved.
The authors suggest that this case offers a rare clue about the brain regions involved in Parkinson’s-related visual hallucinations, particularly implicating the right precuneus and surrounding occipitoparietal cortex. They argue that the disappearance of hallucinations cannot be fully explained by temporary visual field loss or neglect, since the hallucinations remained absent after those deficits improved. The persistence of other symptoms, such as a false sense of presence and misidentification of his wife, also suggests that visual hallucinations and nonvisual psychotic symptoms may arise from partly distinct neural pathways. Because this was a single case and hallucinations were assessed clinically rather than with formal rating tools, the authors emphasize that these findings are hypothesis-generating and should be explored further in future studies.
Reference: Nishijima H, Shibuya E, Seino S, Mikami Y, Tomiyama M. Resolution of Visual Hallucinations in Parkinson’s Disease After Right Occipitoparietal Subcortical Hemorrhage: A Case Report. Cureus. 2026;18(2):e103306. doi: 10.7759/cureus.103306.
