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.



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.