A 72-year-old woman developed difficulty reading, driving, and playing dominoes. Ophthalmologic examination revealed a homonymous hemianopia, but brain MRI showed no abnormality to explain the visual field defect. Neuropsychiatric testing demonstrated severely impaired visual processing (simultagnosia, visual agnosia, visuospatial difficulty). Positron emission tomography revealed hypometabolism of both parietal and occipital lobes consistent with posterior cortical atrophy or the visual variant of Alzheimer disease. Functional neuroimaging should be considered in the setting of a normal MRI among patients with signs and symptoms of the visual variant Alzheimer disease.
Bibliographical noteFunding Information:
The authors reported no financial or commercial interest in any product mentioned or concept discussed in this article. Support: Unrestricted Grant from Research to Prevent Blindness, New York, NY, and the Lions and Lionesses of Minnesota (MSL, ARH).
Copyright 2008 Elsevier B.V., All rights reserved.
- homonymous hemianopia
- positron emission tomography
- posterior cortical atrophy
- visual variant of Alzheimer disease