Presentation
Ataxia.
Patient Data
Age: 65 years
Gender: Male
From the case:
Multiply system atrophy cerebellar type (MSA-C)
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Diffuse cerebellar atrophy and flattening of anterior pons with prominent prepontine cistern. Hot cross bun sign in the pons on T2/FLAIR images.
Multiple deep and subcortical white matter high signal foci on T2/FLAIR, accompanied by dilated perivascular spaces, suggest chronic small vessel disease.
Case Discussion
MSA-C is one of the types of multiple system atrophy (MSA). MSA-C is a neuodegenerative disorder with predominant cerebellar clinical and imaging manifestations. In this case, prominent cerebellar and pontine atrophy, in combination with the presence of the hot cross bun sign, are typical imaging features.
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