Figure 1
Brain Scans and Imaging.
In 2009, a perfusional 99mTc-ECD-SPECT brain scan of the patient revealed bilateral hypoperfusion of the visual association cortices (arrows) (A). Brain magnetic resonance imaging revealed hyperintensities of the optical radiations and bilateral parieto-occipital atrophy (B). In 2012, 99mTc-ECD-SPECT revealed an area of perfusional deficit within the post-central right lobule (arrow) (C). MRI revealed atrophy of the post-central parietal lobule (thick arrow) and increased and asymmetric dilatation of the posterior horn of the right lateral ventricle (small arrow) (D).
Video 1
Posterior Cortical Atrophy: Corticobasal Syndrome at its Final Presentation.
The video demonstrates the patient's left alien hand phenomenon, oculomotor apraxia, right–left confusion, finger agnosia, and ideomotor apraxia. Denomination and vision of single elements were intact. The video shows the patient being asked to repeat “Oggi è una bella giornata di sole (Today is a beautiful sunny day)” to evaluate prosody and intonation; “Quante dita vedi (How many fingers do you see?)” while the examiner was showing two fingers of his right hand to evaluate elementary vision; “Che cosa è un gatto? (What category does a cat belong to?)” to evaluate semantic language; “Mostrami la tua mano destra (Show me you right hand)” to evaluate the recognition of the right and left sides; “Per favore, conti usando le dita della mano (Please, count using your fingers)” to assess finger agnosia; and “Per favore, faccia il segno della croce (Please, make the sign of the cross)” to evaluate ideomotor apraxia.