Medullary Hot-Cross Bun Sign in Multiple System Atrophy-Cerebellar.

Area of Science:

• Neurology
• Neurodegenerative Diseases
• Radiology

Background:

• Multiple-system atrophy (MSA) is a progressive neurodegenerative disorder affecting autonomic, extrapyramidal, pyramidal, and cerebellar systems.
• The pontine hot-cross bun (HCB) sign is a recognized and specific imaging finding in MSA.
• The medullary HCB sign has not been previously described in the medical literature.

Purpose of the Study:

• To report the first documented case of a medullary HCB sign in a patient with MSA-C.
• To explore the potential of the medullary HCB sign as a diagnostic marker for MSA-C.

Main Methods:

• Case report of a patient diagnosed with MSA-C.
• Detailed neuroimaging analysis, focusing on the brainstem.
• Clinical correlation of imaging findings with neurological deficits.

Main Results:

• A distinct medullary HCB sign was identified in the reported case of MSA-C.
• This finding was observed in the absence of the classical pontine HCB sign.
• The presence of the medullary HCB sign may indicate cerebellar subtype MSA (MSA-C).

Conclusions:

• The medullary HCB sign is a newly identified potential imaging biomarker in MSA-C.
• This sign may assist in diagnosing MSA-C, especially when the pontine HCB sign is not apparent.
• Further research is warranted to validate the diagnostic utility of the medullary HCB sign in MSA.