Objective: To report the clinical features, diagnostic process, and treatment strategy of a patient with posterior cortical atrophy (PCA), and to enhance the awareness of peers on this subject through a literature review.

Methods: We analyzed the clinical data of a PCA patient and summaried the literature on the clinical characteristics, diagnostic methods, differential diagnosis, and treatment strategies of the disease.

Results: A 67-year-old male patient presented with a chief complaint of memory decline for over 3 years. The clinical manifestations included progressive visuospatial deficits, visual perceptual impairments, and Gerstmanns syndrome. The neuropsychological assessment of the patient revealed there's a global fluctuating cognitive decline accompanied by relatively preserved early memory. Brain MRI of the patient showed the atrophy in the parietal, occipital, and temporal lobes, among which the parietal lobe being most prominently affected. The analysis of cerebrospinal fluid(CSF) demonstrated the Aβ1-42/Aβ1-40 ratio decreased and the phosphorylated Tau protein (181) increased in the patient's CSF. Overall, the patient was diagnosed with Alzheimer's disease-related posterior cortical atrophy. Treatment strategies of this patient included applying acetylcholinesterase inhibitors and Nmethyl-D-aspartate receptor antagonists.

Conclusion: PCA is a neurodegenerative disorder primarily characterized by visual and spatial cognitive impairments. Its unique clinical presentation makes it prone to misdiagnosis or underdiagnosis. Improving awareness of PCA and combining clinical manifestations, neuropsychological assessments, imaging studies, and biomarker detection can facilitate early diagnosis and intervention.