Figure 1.

The “Hot Cross Bun Sign” or “Cross Sign”, Typical but Not Pathognomonic Sign of Multiple System Atrophy (MSA), Can be Found in the Spinocerebellar Ataxias (SCAs): (A) a case of MSA and (B) SCA 2. Circles – T2 hyperintensity forms a cross on axial images through the pons, representing selective degeneration of pontocerebellar tracts. (A) Axial T2 image shows atrophy in the pons, bilateral middle cerebellar peduncle, and cerebellum. (B) Axial T2 FLAIR image shows severe atrophy in pons and cerebellum. A larger dilatation of the fourth ventricle is also noted.