Social Psychiatry, Vol. 54 No. 2, 2026.
Meeting abstract
https://doi.org/10.24869/spsih.2026.260
When the Pons Speaks: Auditory Hallucinations After Treatment of a Pontine Abscess
Tea Plišić
; Dubrava University Hospital, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia
*
Eugen Divjak
; Dubrava University Hospital, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia
Anja Melada Žaja
; Dubrava University Hospital, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia
* Corresponding author.
Abstract
Auditory hallucinations refer to the perception of
sound in the absence of an external auditory stimulus.
They are most commonly associated with
psychotic disorders, but may also occur in a range
of organic conditions. Particularly interesting are
cases of auditory hallucinations related to brainstem
lesions, including pontine lesions, in which
disruption of central auditory pathways and sensory
modulation mechanisms is presumed. As
post-lesional hallucinations, they may persist for
weeks or months and are interpreted as a “release
phenomenon” following damage to auditory networks.
A review of the available literature shows
that only rare clinical cases from psychiatric practice
have been described. We present a patient
who presented for an initial psychiatric evaluation
two and a half years after completion of systemic
and surgical treatment of a brain abscess
in the pontine region. He is a 44-year-old man
who had previously been healthy. At that time,
his symptoms manifested as left-sided hemiparesis, occipital headache, and diplopia on right gaze.
Treatment was complicated in the postoperative
course by impaired consciousness and difficulty
establishing contact, caused by hemorrhage in
the area of the evacuated abscess. During hospitalization,
external ventricular drainage was performed
twice, after which his neurological status
gradually recovered. During his stay in the intensive
care unit, the patient reported the onset of
visual and sensory hallucinations, which resolved
spontaneously over the course of treatment; however,
auditory hallucinations persisted, such as a
voice saying “you won’t” and the sound of traffic.
After initiation of antipsychotic medication,
the patient reported improvement in the form
of reduced intensity of auditory hallucinations
and less preoccupation with them. Follow-up
radiological imaging (MRI) showed a state after
abscess evacuation and hemorrhage, with postoperative
scar changes and gliosis, as well as olivary
degeneration. The case presented highlights the
complexity of the neural networks responsible
for perception and consciousness and serves as a
reminder that hallucinations are not exclusively
a feature of primary psychiatric disorders. Brainstem
lesions, although rarely associated with auditory
hallucinations, can result in unexpected
neuropsychiatric manifestations that reflect still
insufficiently understood mechanisms of sensory
integration.
Keywords
auditory hallucinations; pontine abscess; brainstem
Hrčak ID:
352915
URI
Publication date:
15.6.2026.
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