Looking into posterior cortical atrophy

Posterior cortical atrophy (PCA) is a dementing syndrome that presents with signs and symptoms of cortical visual dysfunction.¹ The clinical features of PCA reflect dysfunction mainly of the dorsal/occipito-parietal pathway causing Balint syndrome (simultanagnosia, optic ataxia, and ocular apraxia), transcortical sensory aphasia, apraxia, and some or all elements of Gerstmann syndrome (agraphia, acalculia, finger agnosia, right-left disorientation).^1,2 Formal neuropsychological testing has confirmed a relative greater impairment of dorsal visual stream function while frontal lobe functions and memory are relatively preserved until later in the course of the disease.² Structural and functional neuroimaging has consistently revealed atrophy or metabolic changes in the posterior regions of the brain.³ Although PCA is a clinically homogeneous syndrome, there is pathologic heterogeneity. Corticobasal degeneration, dementia with Lewy bodies, subcortical gliosis, fatal familial insomnia, and Creutzfeldt-Jacob disease have all been described as causing PCA.^1,4 However, the most common reported pathologic cause is Alzheimer disease (AD) with increased density of neurofibrillary …