CASE REPORT article
Front. Psychiatry
Sec. Neuroimaging
This article is part of the Research Topic15 years of Frontiers in Psychiatry - Neurobiological Foundations and MethodsView all articles
Case report: Acute hallucinations and delusions following an argument, attributed to temporal lobe hypoperfusion
Provisionally accepted
- 1Department of Psychosomatic Medicine, Mianyang Central Hospital, Mianyang, China
- 2Department of Neurology, Mianyang Central Hospital, Mianyang, China
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PURPOSE: Hallucinations and paranoid delusions are common psychiatric symptoms that can lead to dangerous behaviors such as self-harm and aggression. The temporal lobe is a key region for emotional processing, and its impairment can cause symptoms such as anxiety, depression, cognitive deficits, hallucinations, and delusions. The main purpose of this article is to discuss the effect of improved hypoperfusion on one patient's psychiatric symptoms. PATIENT AND METHODS: A 61-year-old male with untreated hypertension was transferred from the neurology department after developing hallucinations and persecutory delusions following a domestic argument. Perfusion-weighted magnetic resonance imaging (PWI) showed hypoperfusion in the temporal lobe. RESULTS: Fluid therapy was immediately initiated to improve temporal lobe perfusion, and a low dose of anti-psychotic medication was maintained for a short time. After eight days of fluid therapy, the patient's hallucinations and delusions had substantially improved. A subsequent PWI revealed a marked improvement in both the relative cerebral blood flow and relative cerebral blood volume in the left temporal lobe. After discharge, anti-psychotic medications were stopped after one month. No recurrence of psychiatric symptoms was observed during a subsequent five-year monitoring period. CONCLUSION: The initial appearance of psychiatric symptoms requires vigilance for an underlying organic cause. Emotional agitation can cause insufficient cerebral perfusion in stenotic vessels, and hypoperfusion of the left temporal lobe may present as hallucinations or delusions. PWI and similar methods can help to differentiate organic brain disease from primary psychiatric disorders, and early restoration of cerebral blood flow often correlates with a good prognosis.
Keywords: Delusions, Depression, Hallucinations, Perfusion Imaging, Temporal Lobe
Received: 04 Jan 2026; Accepted: 10 Feb 2026.
Copyright: © 2026 Xie, Yang, Yang, Ouyang, Zhang and Shi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Shi
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