Hot cross bun sign,

Authors and affiliations
M. Portet1
Email author
View author's OrcID profile
M. Filyridou1
D. C. Howlett1
1.Radiology Department Eastbourne DGHEast Sussex Healthcare NHS TrustEastbourneEngland
Letter to the Editors
First Online: 28 June 2019
54
Downloads
Dear Sirs,

The “hot cross bun” (HCB) sign refers to a cruciform-shaped hyperintensity within the pons found on T2-weighted magnetic resonance imaging (MRI). This is a rare MR finding, and it is most commonly associated with atrophy of the pons, cerebellum, and putamen in cerebellar variant multiple system atrophy (MSA-C). We report a case of (HCB) in an adult male patient with MSA-C, with emphasis on the clinical presentation, and a discussion of the characteristic imaging findings.

A 76 year old male presented with a 1 year history of slurred speech and a progressive gait disturbance. He had no bradykinesia, rigidity, memory loss or features suggestive of dementia. There was no significant past medical history of note, and no previous family history of similar complaints. The patient was not taking any medications. On examination he was dysarthric, with an ataxic gait. He had mild hypertonia and hyperreflexia, the neurological examination was otherwise unremarkable, and he did not...
This is a preview of subscription content, log in to check access.
Notes
Compliance with ethical standards
Conflicts of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards
This type of article does not require ethical approval in our institution.

References
1.
Peeraully T (2014) Multiple system atrophy. Semin Neurol 34(2):174–181.  https://doi.org/10.1055/s-0034-1381737 (Epub 2014 Jun 25)
CrossRefPubMedGoogle Scholar
2.
Cicilet S, Furruqh F, Biswas A, et al (2017) Hot cross bun and bright middle cerebellar peduncle signs in cerebellar type multiple system atrophy. BMJ Case Rep.  https://doi.org/10.1136/bcr-2017-220576
CrossRefPubMedPubMedCentralGoogle Scholar
3.
Way C, Pettersson D, Hiller A (2019) The ‘Hot Cross Bun’ sign is not always multiple system atrophy: etiologies of 11 cases. J Mov Disord 12(1):27–30.  https://doi.org/10.14802/jmd.18031 (Epub 2018 Dec 19)
CrossRefPubMedGoogle Scholar
4.
Pradhan S, Tandon R (2017) Relevance of non-specific MRI features in multiple system atrophy. Clin Neurol Neurosurg 159:29–33.  https://doi.org/10.1016/j.clineuro.2017.05.008 (Epub 2017 May 10)
CrossRefPubMedGoogle Scholar
Copyright information
© Springer-Verlag GmbH Germany, part of Springer Nature 2019
About this article
CrossMark
Cite this article as:
Portet, M., Filyridou, M. & Howlett, D.C. J Neurol (2019) 266: 2573. https://doi.org/10.1007/s00415-019-09439-1
Received
27 April 2019
 Accepted
18 June 2019
 First Online
28 June 2019
 DOI
https://doi.org/10.1007/s00415-019-09439-1
 Publisher Name
Springer Berlin Heidelberg
 Print ISSN
0340-5354
 Online ISSN
1432-1459
About this journal
Reprints and Permissions