June 24, 2013: Hummingbird Sign in PSP

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June 24, 2013

Hummingbird Sign in PSP

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder characterized by dementia, pseudobulbar palsy, and, perhaps most distinctively, supranuclear ophthalmoplegia that mostly affects vertical gaze. The hummingbird sign is a specific radiologic finding visualized on mid-sagittal MRI sequences that has been reported in approximately 70% of cases of confirmed PSP. Atrophy of the rostral midbrain tegmentum produces a tapered appearance that forms the bill of the hummingbird with the remaining midbrain tegmentum, pons, and cerebellum making up the remainder of the hummingbird.


  1. Kato, N., Arai, K., and T. Hattori. Study of the rostral midbrain atrophy in progressive supranuclear palsy. J Neurol Sci 2003; 210: 57-60.
  2. Graber JI, Staudinger R. Teaching NeuroImages: "Penguin" or "hummingbird" sign and midbrain atrophy in progressive supranuclear palsy. Neurology 2009; 72: e81.

Submitted by: Sarah Nelson, MD
Disclosures: Dr. Nelson reports no disclosures.

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