Hummingbird sign (midbrain)
Last revised by Frank Gaillard on 23 Feb 2022
Citation, DOI, disclosures and article data
Citation:
Gaillard F, Hacking C, Goel A, et al. Hummingbird sign (midbrain). Reference article, Radiopaedia.org (Accessed on 06 Oct 2024) https://doi.org/10.53347/rID-14393
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rID:
14393
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Disclosures:
At the time the article was created Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Last revised:
Disclosures:
At the time the article was last revised Frank Gaillard had no recorded disclosures.
View Frank Gaillard's current disclosures
Revisions:
15 times, by
9 contributors -
see full revision history and disclosures
Systems:
Sections:
Synonyms:
- Penguin sign (midbrain)
The hummingbird sign, also known as the penguin sign, refers to the appearance of the brainstem in patients with progressive supranuclear palsy (PSP).
The atrophy of the midbrain results in a profile of the brainstem (in the sagittal plane) in which the preserved pons forms the body of the bird, and the atrophic midbrain the head, with beak extending anteriorly towards the optic chiasm. Midbrain atrophy is best confirmed with reduction in the midbrain to pons ratio.
References
- 1. Gröschel K, Kastrup A, Litvan I et-al. Penguins and hummingbirds: midbrain atrophy in progressive supranuclear palsy. Neurology. 2006;66 (6): 949-50. doi:10.1212/01.wnl.0000203342.77115.bf - Pubmed citation
- 2. Shukla R, Sinha M, Kumar R et-al. 'Hummingbird' sign in progressive supranuclear palsy. Ann Indian Acad Neurol. 2009;12 (2): 133. doi:10.4103/0972-2327.53087 - Free text at pubmed - Pubmed citation
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Articles:
Cases:
- Progressive supranuclear palsy
- Progressive supranuclear palsy
- Progressive supranuclear palsy
- Hummingbird (photo)
- Hummingbird sign (midbrain)
- Progressive supranuclear palsy (PSP)
- Progressive supranuclear palsy
- Progressive supranuclear palsy
- Hummingbird appearance in midbrain atrophy
- Progressive supranuclear palsy - with hummingbird or penguin sign
- Progressive supranuclear palsy
- Hummingbird sign
Related articles: Neurodegenerative diseases
Neurodegenerative diseases are legion and their classification just as protean. A useful approach is to divide them according to underlying pathological process, although even using this schema, there is much overlap and thus resulting confusion.
-
neurodegenerative MRI brain (an approach)
- measurements and ratios
- midbrain to pons area ratio (for PSP)
- Magnetic Resonance Parkinsonism Index (MRPI) (for PSP)
- frontal horn width to intercaudate distance ratio (FH/CC) (for Huntington disease)
- intercaudate distance to inner table width ratio (CC/IT) (for Huntington disease)
- signs
- hummingbird sign (of PSP)
- Mickey Mouse sign (of PSP)
- morning glory sign (of PSP)
- hot cross bun sign (of MSA-C)
- hockey stick sign (of Creutzfeldt-Jakob disease)
- pulvinar sign (of Creutzfeldt-Jakob disease)
- scoring systems
- measurements and ratios
-
neurodegenerative diseases
-
synucleinopathies
- diseases with Lewy bodies
-
multiple systemic atrophy (MSA)
- MSA-P (striatonigral degeneration)
- MSA-C (olivopontocerebellar degeneration)
- Shy-Drager syndrome
-
tauopathies
-
Alzheimer disease
- typical/classical Alzheimer disease
- variant (e.g. posterior cortical atrophy)
- chronic traumatic encephalopathy (CTE)
- corticobasal degeneration
- frontotemporal lobar degeneration (FTLD) (not all are tauopathies)
- Pick disease
- progressive supranuclear palsy (PSP)
-
Alzheimer disease
- amyloidoses
- TDP-43 proteinopathies
- spinocerebellar ataxias
- Huntington disease
- hereditary spastic paraplegia
- clinically unclassifiable parkinsonism (CUP)
- Unverricht-Lundborg disease
-
prion diseases (not always included as neurodegenerative)
- Creutzfeldt-Jakob disease (sporadic, variant, familial, and iatrogenic)
- fatal familial insomnia
- Gerstmann-Straussler-Scheinker disease
- kuru
- variably protease-sensitive prionopathy
-
synucleinopathies
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