A 60 years old male patient came with complaint of spasticity in bilateral lower limbs. MRI was performed and shown below.: (A) Multiple systemic atrophy- predominant parkinsonism, (B) Progressive supranuclear palsy, (C) Multiple systemic atrophy- predominant cerebellar ataxia, (D) Lewy body dementia
Answer is C. HOT CROSS BUN SIGN- cross shaped hyperintensity in the centre of pons. It is a classic feature of Multisystem atrophy type - C. Multisystem atrophy type - c has involvement of pontocerebellar pathway