Abstract: Visuospatial cognitive impairment associated with vestibular dysfunction has increasingly become a critical concern in clinical vestibular medicine. Current research lacks a systematic integration of the distinct cognitive impairment phenotypes across various vestibular disorders. This study is carried out along four main threads: anatomical foundations, injury mechanisms, assessment methods and disease evidence. We delineate the differential patterns of visuospatial cognitive impairment across six common vestibular disorders(bilateral vestibulopathy, unilateral vestibulopathy, Meniere's disease, benign paroxysmal positional vertigo, vestibular migraine, and persistent postural-perceptual dizziness)and identify assessment tools reported in existing studies that can detect the corresponding declines. By establishing a "Disease-Cognitive Impairment Phenotype-Assessment Tool" clinical decision matrix, this study promotes the paradigm shift from generic screening to disease-specific precision assessment. Furthermore, by critically dissecting methodological confounders(such as cognitive reserve, hearing loss, and emotional comorbidities)that contribute to conflicting findings in the literature, we clarify current diagnostic misconceptions. This study proposes a theoretical model of "diagnosis-guided precision assessment", providing a robust framework for the early identification, clinical stratification, and standardized management of vestibular-related visuospatial cognitive impairment.

Key words: Vestibular disorders, Visuospatial cognitive function, Multisensory integration, Visuospatial cognitive assessment