Hot cross bun sign (pons)

Last revised by Dr Francis Deng on 08 Apr 2021

The hot cross bun sign refers to the MRI appearance of the pons when T2 hyperintensity forms a cross on axial images, representing selective degeneration of transverse pontocerebellar tracts and median pontine raphe nuclei. It has been described in a variety of neurodegenerative diseases 1:

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Cases and figures

  • Figure 1: hot cross buns
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  • Case 1: MSA
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  • Case 2: JC virus granule cell neuronopathy
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  • Case 3: MSA
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  • Case 4: MSA
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