Progressive Supra-nuclear palsy – A Case Study

Clinical History: A 49 years old male presented with over 2 years history of:

1. 1. Difficulty in moving eyes and lack of control over the eyes.
   2. Stiffness in both upper and lower limbs.
   3. Difficult speech and swallowing.
   4. Mild dementia.
   5. No h/o past vascular insult/stroke.

Plain MRI findings revealed:

1. 1. The mid-sagittal T1WI shows that the rostral midbrain tegmentum appears small in size with a concave profile (instead of normal convex profile).
   2. Pons appears normal.
   3. Mild dilatation of the third ventricle is noted.
   4. Increased signal intensity is noted in the periaqueductal gray matter on T2WI and FLAIR sequences.