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Posterior cortical atrophy

Overview

Posterior cortical atrophy is a degenerative brain and nervous system (neurological) syndrome that results in difficulty with eyesight and processing visual information. Common symptoms include difficulties with reading, judging distances, and reaching for objects, as well as trouble with calculations and recognizing objects and familiar faces. Over time this condition may cause your memory and thinking abilities (cognitive skills) to decline.

Posterior cortical atrophy changes a person's ability to purposefully process visual and spatial information. This difficulty is secondary to atrophy of the back (posterior) part of the brain. This is the region responsible for visual processing and spatial reasoning.

Posterior cortical atrophy is most commonly due to Alzheimer's disease (over 80%) but may be due to other neurological conditions, such as Lewy body dementia or corticobasal degeneration.

Symptoms

Posterior cortical atrophy symptoms vary widely between individuals and over time. Symptoms tend to worsen gradually. Common signs and symptoms include difficulties with:

  • Reading, spelling or math
  • Driving
  • Getting dressed
  • Telling the difference between objects that are moving and those that are still
  • Identifying how far away objects are
  • Using everyday objects or tools
  • Identifying left from right

Other common signs and symptoms include:

  • Hallucinations
  • Anxiety
  • Confusion
  • Changes in behavior and personality

Later in the course of the disease, memory problems may occur.

Causes

Experts don't understand what causes posterior cortical atrophy. Possible causes include Alzheimer's disease and Lewy body dementia. There are no identified genetic mutations found to cause the condition.

Risk factors

Further study is needed to determine whether the risk factors for Alzheimer's disease may play a role in posterior cortical atrophy.

Diagnosis

Because the first symptoms are often visual, it's not uncommon for posterior cortical atrophy to be misdiagnosed as a vision disorder. It's important to see a neurologist who can correctly diagnose your condition.

To diagnose posterior cortical atrophy, your doctor will review your medical history and symptoms, including vision difficulties, and conduct a physical examination and a neurological examination.

Your doctor may order several tests to help diagnose your condition and exclude other conditions that may cause similar symptoms, including:

  • Mental status and neuropsychological tests. Your doctor will ask you questions and conduct tests to assess your cognitive skills. You may have psychiatric assessments to test for depression or other mental illnesses.
  • Blood tests. Your blood may be tested for vitamin deficiency, thyroid disorders and other conditions that may be causing your symptoms.
  • Ophthalmology examination. Your doctor will conduct a vision test to determine whether another condition such as a problem within your eyes is causing your vision symptoms.
  • Magnetic resonance imaging (MRI). An MRI machine uses powerful radio waves and a magnetic field to create a 3D view of your brain. In this test, your doctor can view abnormalities in your brain that may be causing your symptoms.
  • Positive emission tomography (PET) or single-photon emission computerized tomography (SPECT). In these tests, a doctor injects a small amount of radioactive material and places emission detectors on your brain. PET provides visual images of brain activity. SPECT measures blood flow to various regions of your brain.

Treatment

There are no treatments to cure or slow the progression of posterior cortical atrophy. While some research suggests that drugs commonly used to slow the progression of Alzheimer's disease may help manage symptoms of posterior cortical atrophy, this hasn't been proved and more research is needed.

Some therapies and medications can help you manage your condition. Treatment options to help manage symptoms of posterior cortical atrophy may include:

  • Medications. Your doctor may give you medications to treat symptoms, such as depression or anxiety.
  • Physical, occupational or cognitive therapy. These therapies may help you regain or retain skills that are affected by posterior cortical atrophy.

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