Hot cross bun sign (pons)

Changed by Rohit Sharma, 26 Mar 2019

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The hot cross bun sign refers to the MRI appearance of the pons in a variety of neurodegenerative diseases.

T2 hyperintensity forms a cross on axial images through the pons, representing selective degeneration of pontocerebellar tracts. It has been described in ¹:

multiple system atrophy (MSA)
spinocerebellar atrophy types 2 and 3
~~parkinsonism secondary to~~cerebral vasculitis (causing Wallerian degeneration of pontocerebellar tracts) ⁴
variant Creutzfeldt-Jakob disease (vCJD)
JC virus granule cell neuronopathy ³

~~-<li>parkinsonism secondary to vasculitis</li>~~
+<li>cerebral vasculitis (causing <a title="Wallerian degeneration" href="/articles/wallerian-degeneration">Wallerian degeneration</a> of pontocerebellar tracts) 4
+</li>
~~-<a title="JC virus" href="/articles/john-cunningham-virus-1">JC virus granule cell neuronopathy</a> 3~~
+<a href="/articles/jc-virus-granule-cell-neuronopathy">JC virus granule cell neuronopathy</a> 3

References changed:

4. Muqit MM, Mort D, Miskiel KA, Shakir RA. "Hot cross bun" sign in a patient with parkinsonism secondary to presumed vasculitis. (2001) Journal of neurology, neurosurgery, and psychiatry. 71 (4): 565-6. <a href="https://www.ncbi.nlm.nih.gov/pubmed/11601421">Pubmed</a>

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Hot cross bun sign (pons)

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