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The incredible shrinking brain

M H Levy1, W M Hart, F M Sonstein

  • 1Sarasota Retina Institute, Florida, USA.

Survey of Ophthalmology
|January 1, 1995
PubMed
Summary

Alzheimer's disease with amyloid angiopathy caused progressive visuospatial decline in a 65-year-old woman. Imaging revealed parietal and occipital lobe atrophy, leading to simultagnosia but not Balint's syndrome.

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Area of Science:

  • Neuroscience
  • Neurology
  • Ophthalmology

Background:

  • Alzheimer's disease (AD) is a progressive neurodegenerative disorder.
  • Cerebral amyloid angiopathy (CAA) is a common finding in AD, increasing hemorrhage risk.
  • Visuospatial abnormalities can manifest in AD, but the specific presentation varies.

Observation:

  • A 65-year-old woman with AD and CAA experienced progressive visuospatial deficits over eight years.
  • Neuroimaging showed focal parietal and occipital lobe atrophy without evidence of cerebral hemorrhage.
  • The patient presented with simultagnosia, a condition where individuals can only perceive one object at a time.

Findings:

  • The patient's presentation mimicked Balint's syndrome but lacked key features like ocular dysmetria and optic ataxia.
  • Despite significant occipital lobe atrophy, visual acuity and visual fields remained stable.
  • Occipital lobe biopsy confirmed the pathological findings without complications.

Implications:

  • This case highlights the diverse neurological manifestations of Alzheimer's disease, even in the presence of amyloid angiopathy.
  • Understanding these specific visual-spatial deficits is crucial for accurate diagnosis and patient management.
  • Further research into the relationship between AD, CAA, and specific visual processing deficits is warranted.

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