Rare case report links visual hallucinations to moyamoya disease in an 11-year-old girl

Researchers have reported an unusual case in which an 11-year-old girl with moyamoya disease developed a psychotic disorder dominated by visual hallucinations, a presentation the authors describe as exceedingly rare, with only three comparable cases previously reported in the literature.

According to the report, published in BMC Psychology, a small number of patients may present with psychiatric symptoms such as depression, anxiety, and cognitive impairment, but psychotic disorders characterised predominantly by visual hallucinations have been documented only rarely.

The girl was admitted to hospital presenting with limb shaking. Magnetic resonance imaging and digital subtraction angiography revealed occlusions at the terminal portions of both internal carotid arteries, significant stenosis of the right posterior cerebral artery, and the development of a collateral vascular network at the base of the brain. These findings led to a diagnosis of moyamoya disease.

Following the diagnosis, she underwent revascularisation surgery for the right hemisphere, which was performed successfully. However, two years after the operation, the patient developed psychiatric symptoms, including visual hallucinations and fear.

The psychiatric symptoms resolved completely after treatment with quetiapine and sertraline, and no recurrence was observed over a five-year follow-up period, the authors report.

The case report was written by Xuexia Yuan, Ruoxin Niu, Hao Yu, Cong Zhou, and Deguo Liu, and was published as an open-access case report on 15 September 2026. The authors state that the report aims to enhance clinical recognition of psychiatric symptoms in patients with moyamoya disease and to emphasise that a multidisciplinary approach involving neurology and psychiatry services for early diagnosis and appropriate management is crucial for significantly improving patient prognosis.

As a single-case report, the findings describe one patient’s experience and cannot establish how commonly such psychotic symptoms occur among people with moyamoya disease, nor can they determine the underlying mechanism linking the cerebrovascular disease to the psychiatric presentation. The authors note that the article was shared early to provide faster access to peer-reviewed, accepted research, and that this version is subject to further edits before the final version of record.

Subject of Research: A case report of a psychotic disorder with predominating visual hallucinations in an 11-year-old girl with moyamoya disease.

Article Title: Psychotic disorder with predominating visual hallucinations in moyamoya disease: a case report

Article References: Yuan, X., Niu, R., Yu, H., Zhou, C., & Liu, D. (2026). Psychotic disorder with predominating visual hallucinations in moyamoya disease: a case report. BMC Psychology. https://doi.org/10.1186/s40359-026-05528-9

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05528-9

Keywords: moyamoya disease, visual hallucinations, psychotic disorder, case report, revascularisation surgery, cerebrovascular disorder, quetiapine, sertraline, BMC Psychology, psychiatric symptoms, Psychotic, disorder