Hot-cross bun sign of multiple system atrophy

Case contributed by Frank Gaillard
Diagnosis almost certain

Patient Data

Age: Adult

Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.

Selected T2 and FLAIR axial images through the pons demonstrate a prominent high T2 signal in the transverse pontocerebellar tracts and median pontine raphe nuclei forming of the so-called hot cross bun sign. There is also pontine and cerebellar volume loss as well as increased T2 signal in the middle cerebellar peduncles.

Case Discussion

Typical, albeit pronounced, hot cross bun sign in a patient with known multiple system atrophy

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