Abstract

Multiple system atrophy (MSA) is a synucleinopathy, characterized by combined manifestations of cerebellar, parkinsonian, and autonomic features. It is subdivided into two main types-parkinsonian MSA (MSA-P) and cerebellar MSA (MSA-C). Magnetic resonance imaging (MRI) of the brain is a valuable tool in diagnosing this condition as it shows many characteristic features, such as the 'hot cross bun' sign. This is a cruciform hyperintensity imaging feature, seen at the level of pons in axial T2-weighted MRI images. This sign is typically seen in patients with MSA-C. This reported case describes a patient with MSA-C with characteristics brain MRI features.

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