Abstract
The authors report a classical case of progressive supranuclear palsy in which CT, MRI (magnet resonance image), SPECT (singlephoton emission CT) studies were performed.
CASE: A 68-year-old female initially presented with slurred speech and movement accompanied with inclination to fall two years before. The symptoms did not become worse after then, however she developed dementia and unsteadiness of gait, yielded to all day bed rest about 20 months after the initial symtoms. And voluntary speech and movement became rare. On admission in January 1989, neurological examination revealed supranuclear vertical gaze palsy, subcortical dementia, peculiar nuchal rigidity with retroflexion, increased deep tendon reflexes without pathological reflexes, marked rigidity in extremities, pseudobulbar palsy and retropulsion.
1) CT scan revealed the atrophy of the midbrain and diffuse cerebral atrophy, developed for two years.
2) MRI sagittal image, considered to be essential radiological diagnostic method for PSP, clearly revealed the atrophy of the midbrain and tegmentum of the pons.
3) SPECT revealed relative low blood flow in the bifrontal base as well as midbrain and basal ganglia.
