Posterior cortical atrophy: a review of the literature

The past three decades have seen an accumulation of reports of neurodegenerative disease with disruption to visual processing. Disorders of both visuospatial processing and visual recognition have been described, though the former predominate. But the conundrum of posterior cortical atrophy (PCA) is that while the clinical presentation is relatively homogeneous, the nosological status remains something of a puzzle. Many cases coming to pathology have had Alzheimer's Disease (AD) but in a different distribution from that seen in typical AD (tAD). Patients with non-specific subcortical gliosis and, more occasionally, Creutzfeldt Jacob disease, neither of which have an obvious affinity with PCA, have also been described. On the other hand, no case of PCA has been reported with the pathology of either corticobasal degeneration or dementia with Lewy Bodies, both of which do commonly present with prominent parietal symptomatology.