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Multisystem Atrophy - Cerebellar Type (MSA-C)

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  • 70 year old with marked pontine and middle cerebellar peduncle atrophy.
  • Cruciform T2-hyperintensity in the pons and T2-hyperintensity in the right middle cerebellar peduncle.

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  • 60-year-old patient presented with ataxia and dysarthria.
  • MRI showed marked pontine and moderate cerebellar volume loss. Cruciform high signal in the pons represented the hot cross bun sign.

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  • A 70-year-old patient presented with ataxia causing frequent falls.
  • MRI showed severe atrophy affecting the pons, middle cerebellar peduncles, and cerebellar hemispheres.
  • The hot cross bun sign was present on FLAIR.
  • DaTSCAN showed normal availability of the presynaptic dopamine transporters - as might be expected in MSA-P.