MULTIPLE SYSTEM ATROPHY (MSA)
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Figure 9.2 Multiple system atrophy: cerebellar type (MSA-C). (A) Axial and (B) sagittal T2-weighted MRI. Profound volume loss in the cerebellar hemispheres, vermis, middle cerebellar peduncles, and brainstem is typical with predilection for the pons and olivary nuclei. (A) Note prominence of intrapontine CSF clefts (black arrow) described as the “hot cross bun” sign. (B) Sagittal MRI demonstrates pontine volume loss with flattening of the anterior surface and widening of the pontomedullary angle (black arrow).
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