Seeing things that are not really there after a stroke can be frightening and confusing. Many stroke survivors worry that they are "losing their mind" or developing dementia. However, visual hallucinations can sometimes occur after a stroke, particularly when areas of the brain involved in vision have been affected. Learn why visual hallucinations happen, what they may look like and whether they can improve over time.

After your stroke...

You notice something unusual.

Perhaps you see a person standing in the room.

A small animal running across the floor.

Patterns on the wall moving.

Or shadows that disappear when you look more closely.

You know something is not quite right.

You begin wondering...

"Am I going crazy?"

Or...

"Why am I seeing things that are not there?"

The good news is...

Visual hallucinations after stroke are more common than many people realise, and they do not automatically mean that you have dementia or a serious mental illness.

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The Good News

The brain is responsible for processing everything we see.

After a stroke, damage to visual areas of the brain can occasionally cause the brain to create images that are not actually present.

Many people experience:

✓ Temporary symptoms.

✓ Improvements over time.

✓ Better understanding of triggers.

✓ Reduced fear once they know what is happening.

Recovery and symptom improvement are often possible.

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What Are Visual Hallucinations?

Visual hallucinations involve seeing things that are not physically present.

These experiences can range from:

✓ Simple shapes.

✓ Flashes of light.

✓ Colours or patterns.

✓ Animals.

✓ Faces.

✓ People.

✓ Objects.

Hallucinations can appear very real.

Some people realise immediately that they are not real.

Others may initially feel uncertain.

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Why Can Stroke Cause Visual Hallucinations?

A stroke can damage areas involved in:

✓ Vision.

✓ Visual processing.

✓ Attention.

✓ Sensory interpretation.

When these areas are disrupted, the brain may begin generating its own visual images.

This is similar to how phantom limb sensations occur after limb loss.

The brain is attempting to make sense of incomplete information.

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Charles Bonnet Syndrome

One important cause of visual hallucinations after stroke is Charles Bonnet Syndrome (CBS).

This condition occurs when reduced visual input causes the brain to create images.

It is more common in people who have:

✓ Visual field loss.

✓ Significant vision impairment.

✓ Eye disease.

✓ Damage to visual pathways after stroke.

Importantly:

People with Charles Bonnet Syndrome usually know that the images are not real.

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What Do Hallucinations Look Like?

Visual hallucinations vary greatly.

People may report seeing:

✓ Children.

✓ Strangers.

✓ Animals.

✓ Insects.

✓ Geometric patterns.

✓ Faces.

✓ Buildings.

✓ Objects moving.

Hallucinations may be:

✓ Colourful.

✓ Detailed.

✓ Brief.

✓ Repetitive.

Some are neutral, while others may feel frightening.

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Are Visual Hallucinations a Sign of Dementia?

Not necessarily.

This is a very common fear.

Visual hallucinations after stroke do not automatically mean:

✗ Dementia.

✗ Psychosis.

✗ Mental illness.

The brain has simply been injured.

Hallucinations can occur as a result of changes in visual processing.

However, medical assessment is important to identify the underlying cause.

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Why Do Hallucinations Often Occur in the Evening?

Many people notice symptoms are worse when they are:

✓ Tired.

✓ In dim lighting.

✓ Stressed.

✓ Alone.

✓ Resting quietly.

Reduced visual stimulation may increase the likelihood of hallucinations in some individuals.

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Fatigue Can Make Symptoms Worse

Stroke fatigue can significantly worsen neurological symptoms.

When the brain becomes tired, it may struggle even more to process visual information.

Symptoms may become more noticeable when:

✓ Sleep deprived.

✓ Physically exhausted.

✓ Mentally overstimulated.

✓ Unwell.

Managing fatigue may help reduce symptom severity.

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Can Medications Cause Hallucinations?

Sometimes.

Certain medications may contribute to hallucinations in some individuals.

Possible contributors may include:

✓ Some pain medications.

✓ Certain sleep medications.

✓ Some medications affecting the nervous system.

Always discuss new symptoms with your doctor.

Do not stop medication without medical advice.

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Can Visual Hallucinations Improve?

Yes.

Many people experience:

✓ Reduced frequency.

✓ Less distress.

✓ Improved understanding.

✓ Complete resolution.

Recovery depends on:

✓ Stroke location.

✓ Severity of visual impairment.

✓ Overall neurological recovery.

✓ Management of contributing factors.

The brain often continues adapting over time.

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What Can Help?

Strategies that may help include:

✓ Improving lighting.

✓ Reducing fatigue.

✓ Moving your eyes or blinking.

✓ Looking directly at the hallucination.

✓ Increasing visual stimulation.

✓ Speaking openly about symptoms.

Understanding what is happening often significantly reduces anxiety.

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Should You Tell Your Doctor?

Yes.

Many people are embarrassed to discuss hallucinations.

However, it is important to seek medical advice.

Assessment may help determine whether symptoms are related to:

✓ Visual impairment.

✓ Stroke location.

✓ Medication.

✓ Other neurological conditions.

You are not alone.

Healthcare professionals are familiar with these symptoms.

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When Should You Seek Urgent Medical Attention?

Seek urgent medical attention if hallucinations:

✓ Suddenly worsen.

✓ Occur alongside new stroke symptoms.

✓ Cause severe confusion.

✓ Are associated with loss of consciousness.

✓ Develop alongside sudden changes in vision.

Prompt assessment is important.

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My Perspective

After a stroke...

Seeing things that are not there can feel terrifying.

Many people keep these experiences secret because they fear being judged.

They worry that they are developing dementia.

Or losing touch with reality.

But visual hallucinations can sometimes simply reflect the way the injured brain is processing visual information.

You are not "going crazy."

Your brain has been through a significant injury.

And for many people, symptoms gradually improve with time.

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Frequently Asked Questions

Are visual hallucinations common after stroke?

They are not uncommon, particularly when visual areas of the brain have been affected.

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Does this mean I have dementia?

No.

Visual hallucinations alone do not automatically indicate dementia.

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What is Charles Bonnet Syndrome?

It is a condition where reduced visual input causes the brain to generate visual images.

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Will the hallucinations go away?

Many people experience improvement over time.

Some experience complete resolution.

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Should I tell my doctor?

Yes.

It is always important to discuss new neurological symptoms with your healthcare professional.

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Key Takeaways

✓ Visual hallucinations can occur after stroke.

✓ They do not automatically mean dementia or mental illness.

✓ Charles Bonnet Syndrome may occur when vision has been affected.

✓ Fatigue and poor lighting can worsen symptoms.

✓ Many people improve over time.

✓ Medical assessment is important to determine the cause.

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Related Articles

Continue learning about vision problems after stroke with these helpful guides:

Can Vision Return After a Stroke? – Learn about visual recovery after stroke.

Dizziness and Vision Problems After Stroke – Understand how visual problems can affect balance.

Visual Neglect After Stroke – Learn why one side of space may be ignored.

Double Vision After a Stroke – Discover why double vision develops.

Hallucinations After a Stroke – Learn about other types of hallucinations and why they occur.

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Final Thoughts

After a stroke...

Seeing things that are not there can feel frightening and isolating.

But these experiences are often a symptom of how the brain is processing visual information after injury.

You are not alone.

You are not "losing your mind."

And for many people, symptoms become less distressing and improve over time.

Understanding what is happening is often the first step towards reducing fear and regaining confidence.