Syndrome, SRO

The progressive supranuclear palsy (PSP), AKA Steele-Richardson-Olszewski syndrome, is a neurodegenerative disease with brain atrophies. Brain MRI features midbrain atrophy such as hummingbird sign, Mickey Mouse appearance, etc.

Cases

1

This patient presents with right hand and left foot tremors, suggestive of Parkinsonism. A brain MRI without contrast showed midbrain atrophy with presentations indicating PSP.

(A and B): Thinned right superior cerebellar peduncle (magenta arrow) and left superior cerebellar peduncle (yellow arrow).
(C): Hummingbird sign.
(D): Mickey mouse sign.