Demographics:
63 years old, Female
Indication:
Parkinsonism
Findings
- Marked pontocerebellar atrophy with cruciform T2 signal hyperintensity in the pons at the level of the middle cerebellar peduncles ("hot crossed bun" sign)
- Mild generalized cerebral volume loss
- Patchy T2/FLAIR signal hyperintensity in the subcortical and periventricular white matter, which although nonspecific likely relates to chronic small vessel disease
Diagnosis
Cerebellar ataxia-type multiple system atrophy (MSA-C)
Sample Report
Marked pontocerebellar atrophy out of proportion to relatively mild supratentorial parenchymal volume loss. In combination with the finding of cruciform T2 signal hyperintensity in the pons at the level of the middle cerebellar peduncles ("hot crossed bun" sign), this appearance is most suggestive of cerebellar ataxia-type multiple system atrophy (MSA-C).
Discussion