Multisystem atrophy (MSA)

Case contributed by Frank Gaillard
Diagnosis almost certain


Progressive ataxia gait dysfunction, dysarthria and dysphagia.

Patient Data

Age: 50 years
Gender: Male

High signal is seen on T2/FLAIR crossing left to right and AP in the pons, creating the hot-cross bun appearance. Signal drop out is also seen in the basal ganglia.

Case Discussion

This case illustrates features suggestive of multiple system atrophy. 

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