Posterior (bilateral parieto-occipital) cortical atrophy: a case study/Posterior (bilateral parietooksipital) kortikal atrofi: bir olgu sunumu

Scientific Background: Primary degenerative dementia can show different features in the early stages and can start with asymmetric or symmetric focal degeneration. Posterior cortical atrophy is a rare progressive dementia syndrome which can be evaluated, using neuropsychological tests and neuroimaging techniques, along with clinical features. Definitive diagnosis is made histopathologically. Objective: To discuss the clinical features of a case with posterior cortical atrophy, characterized by progressive visuospatial disorder, and the differential diagnosis, under the light of related literature. Results: Neurocognitive assessment revealed a serious visuospatial and constructional disturbance as well as facial recognition defects, dressing apraxia and agraphia, and a mild memory and verbal fluency impairment. Cranial MRI demonstrated bilateral parieto-occipital atrophy, and the SPECT investigation showed decreased perfusion in the right temporoparieto occipital region compared to the left hemisphere. Routine and other laboratory investigations were normal. Conclusion: The patient was started on memantine with a daily dose of 20 mg, twice a day. After four months, he became temporarily able to drive and park his tractor, but, the symptoms progressed later. (Archives of Neuropsychiatry 2009; 46: 192-61 Key words: Posterior cortical atrophy, degenerative dementia, visuospatial dysfunction Bilimsel Zemin: Primer dejeneratif demanslar erken donemlerde farkli ozellikler gosterebilirler. Simetrikya da asimetrikfokal dejenerasyonla baslayabilirler. Posterior kortikal atrofi daha nadir gorulen bir demans sendromudur. Klinik bulgular, noropsikolojik inceleme ve norogoruntuleme ile degerlendirmek mumkundur. Kesin tani patolojik olarak yapilir. Amac: Fokal primer demanslardan bilateral parietooksipital atrofiyle giden vizuospasyal fonksiyon bozukluklarin on planda oldugu bir olgunun klinik ozelliklerini cesitli yonleriyle literatur bilgileriyle tartismaktir. Bulgular: Norokognitif degerlendirmede, vizuospasyal ve konstruksiyon yetilerinde, yuz tanimada, praksik fonksiyonlarda, yazi yazmada belirgin, bellekte, verbal akicilikta hafif bozukluk saptanmistir. Kraniyal MRG'de parietooksipitallerde belirgin atrofi, SPECT'te sagda temporoparitalde belirgin oksipital bolgeyede perfuzyon azligi saptanmistir. Rutinler ve diger laboratoryr incelemeleri normal bulunmustur. Sonuc: Memantin baslanan hastanin, 4 ay sonraki degerlendirmesinde, traktoru gecici bir sure kullanabilmis