FLAIR MRI images showing hot cross bun sign and cerebellar atrophy
Hot cross bun

Hot cross bun sign is typically seen in patients with multiple system atrophy (MSA). This refers to cruciform hyperintensity seen in pons (as seen in the left side FLAIR MRI image). The sign is due to selective loss of myelinated transverse pontocerebellar fibres and neurons in the pontine raphe, with preservation of the pontine tegmentum and corticospinal tracts. This sign is best seen on axial T2W or FLAIR images.

Published by Dr Sudhir Kumar MD (Medicine) DM (Neurology)

I am a doctor with 25 years experience. I have worked as a neurologist for about 20 years. Educating public and healthcare professionals is very dear to me. This is possible due to my interactions with thousands of patients and their caregivers. I salute the patients who suffer and it is our duty to minimise suffering by preventing diseases and ensuring prompt diagnosis and treatment of those already affected.

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