Multiple system atrophy (cerebellar type, MSA-C)

Case contributed by Dr Ayaz Hidayatov

Presentation

A patient presented with progressive ataxia and bilateral lower extremity spacticity.

Patient Data

Age: 50-55
Gender: Female

Significant volume loss involving both cerebellar hemispheres, middle and superior cerebellar peduncles, with atrophy and flattening of the pons and medulla. There is linear cruciform hyperintensity in the pons (hot cross bun sign), best seen on axial T2 and FLAIR images. No diffusion restriction was noted. 

The supratentorial brain is unremarkable.

The findings mentioned above are most compatible with multiple system atrophy (cerebellar type, MSA-C). 

Case Discussion

Multiple system atrophy (MSA-C) is a neurogenerative disease. This case illustrates the typical findings of cerebellar type of multiple system atrophy. 

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