Hot cross bun sign refers to the cruciform-shaped hyperintensity on T2W axial magnetic resonance images (MRI) in multisystem atrophy due to the selective loss of myelinated transverse pontocerebellar fibers and neurons in the pontine raphe and sparing of the pontine tegmentum and corticospinal tracts [Figure 1, Figure 2].[1] The name derives from a sweet spiced bun baked by the Christian church...

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OBJECTIVE To investigate whether proton density-weighted imaging can detect the "hot cross bun" sign in the pons in multiple system atrophy with predominant cerebellar ataxia significantly better than T2-weighted imaging at 3T. METHODS Sixteen consecutive patients with multiple system atrophy with predominant cerebellar ataxia according to the Consensus Criteria were reviewed. Axial unenhance...

A 65-year-old man came to our clinic with progressive disequilibrium and gait problem since 6 years. During this period, he had also urinary incontinency. On neurologic examination, he had scanning speech and bidirectional nystagmus. There was hypokinesia in upper and lower limbs and on cerebellar tests finger to nose and heel to shin were impaired (severe dysmetria); he was unable to walk with...

The hot cross bun sign is characterized by cruciform T2 signal hyperintensity in the pons and has been reported to be a specific but not pathognomic for multiple system atrophy. It reflects degeneration of pontine neurons and transverse pontocerebellar fibers, regardless of the underlying pathogenic process. Here, we report a case of hot cross bun sign following bilateral pontine infarction due...

BACKGROUND Paraneoplastic neurological syndromes (PNS) are rare remote effect of cancer. The antibodies and tumors associated with PNS have been well described, but there are still many clinically suspected cases in which no tumor or antibody can be identified. This is the first report of PNS showing hot cross-bun sign and caused by exceptionally rare underlying malignancy, such as burned-out t...