The Hummingbird Sign

Clinical Image

Austin J Radiol. 2021; 8(13): 1180.

The Hummingbird Sign

Wilson B1*, Waïs A1, Sara EZ1, Raïssa K1, Najwa EK2, Meryem F2, Mohammed J3 and Firdaous T2

1Department of Neuroradiology, Mohamed V University, Rabat, Morocco

2Professor, Department of Neuroradiology, Mohamed V University V, Rabat, Morocco

3Professor, Chef of Service, Department of Neuroradiology, Mohamed V University, Rabat, Morocco

*Corresponding author: Wilson Bizimana, Department of Neuroradiology, Mohamed V University, Rabat, Morocco

Received: November 19, 2021; Accepted: December 06, 2021; Published: December 13, 2021

Keywords

Hummingbird sign; Progressive supranuclear Palsy; MRI

Clinical Image

Progressive supranuclear palsy also known as Steele-Richardson syndrome (PSP-RS) is a neurodegenerative disease that manifests as axial rigidity, unstable posture, and supranuclear gaze palsy. Thus, there is a marked atrophy of the middle of the brain involving midbrain. The MRI will show on the median sagittal slices weighted in T1 the sign of the Humming-bird or the sign of the Penguin (Figure 1) which describes the flat or concave aspect of the mesencephalic tegmentum. This sign, which recalls the appearance of the beak of the Hummingbird Bird or the beak of the Penguin (Figure 2), is typical of PSP-RS, with a specificity of 99.5% [1]. This sign is often associated with the Morning Glory Sign which has a specificity of 97.7%, observed on axial slices weighted of the MRI, corresponding to the concave aspect of the lateral margin of the Tegmentum of the midbrain [2]. Those appearance reflect a reduction in the anteroposterior diameter of the mesencephalon testifying to its atrophy [1,2].

Figure 1: Brain MRI, sagittal T1-Weighted showing atrophy of the mesencephalic with the sign of Hummingbird.

    

    
    

    

    Figure 1: Brain MRI, sagittal T1-Weighted showing atrophy of the
mesencephalic with the sign of Hummingbird.

Figure 2: Image of Beak of Hummingbird and Penguin.

    

    
    

    

    Figure 2: Image of Beak of Hummingbird and Penguin.

References

  1. M Jasim, A Jalala, MK Menon. Humming bird sign’, ‘Mickey Mouse sign’, and ‘morning glory sign’ in progressive supranuclear palsy. Menoufia Med J. 2017; 30: 325-326.
  2. A Righini, A Antonini, R De Notaris, E Bianchini, N Meucci, G Sacilotto, et al. MR Imaging of the Superior Profile of the Midbrain: Differential Diagnosis between Progressive Supranuclear Palsy and Parkinson Disease. AJNR Am J Neuroradiol. 2004; 25: 927-932.

Citation: Waïs A, Wilson B, Raïssa K, Meryem F, Mohamed J, Firdaous F, et al. The Hummingbird Sign. Austin J Radiol. 2021; 8(13): 1180.