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Posterior cortical atrophy — SCE Neurology MCQ

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HardCognitive NeurologyPosterior cortical atrophySCE Neurology

A patient has simultanagnosia, optic ataxia and dressing apraxia with preserved early memory. MRI shows bilateral parieto-occipital atrophy, right greater than left. Which network is principally affected?

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Correct answer: A — Posterior parietal–occipital association cortex, after checking contraindications

The best answer is “Posterior parietal–occipital association cortex, after checking contraindications”. The combination is a posterior cortical syndrome involving dorsal visual and parietal association networks. “Dominant anterior temporal semantic network” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Bilateral hippocampal memory network” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Primary motor cortex and corticospinal tracts” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here. “Ventromedial prefrontal behavioural network” remains a plausible alternative in a different presentation, but it does not fit the decisive finding or management threshold here.

Reference: Consensus classification of posterior cortical atrophy: https://pmc.ncbi.nlm.nih.gov/articles/PMC5788455/