Progressive supranuclear palsy

Case contributed by Dr Utkarsh Kabra

Presentation

Dementia, ataxia and parkinsonian symptoms.

Patient Data

Age: 75 years
Gender: Male
MRI

Disproportionate atrophy of the midbrain is seen with concavity of its superior and dorsolateral margins. Midline sagittal midbrain to pons area ratio is approximately 0.12 (the normal value is approximately 0.24).

Lacunar infarcts, discrete, confluent areas of ischemic demyelienation are seen in bilateral periventricular, deep and subcortical white matter.

Convexity sulci, lateral ventricles and surface of cerebellar folia are prominent – likely diffuse cerebral and cerebellar atrophy.

Case Discussion

In the given clinical setting, disproportionate atrophy of midbrain and reduced midbrain to pons ratio (0.12) suggest possibility of a neurodegenerative disorder such as progressive supranuclear palsy.

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Case information

rID: 73767
Published: 28th Jan 2020
Last edited: 29th Jan 2020
Inclusion in quiz mode: Included

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