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There is marked atrophy of the pons, midbrain, middle cerebellar peduncles and cerebellum diffusely. In addition there is central pontine signal abnormality is present conforming to the so-called "hot cross bun sign". No other focal abnormality identified. Supratentorial cerebral volume is age appropriate. Mesial temporal lobes appear normal. No intracranial mass, collection, evidence of restricted diffusion, or perfusion abnormality.