Reason: progressive ataxia, please look for hot cross bun sign History: ataxia There is atrophy of the cerebellum and brainstem with a cross a cross bun sign.No abnormal enhancing lesions are identified within the brain parenchyma.A punctate T2 signal hyperintensity in the right external capsule is probably of little clinical significance.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrator minor opacity in the left sphenoid sinus and left maxillary sinus. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
Atrophy of the posterior fossa structures are suspicious for SCA or MSA with cross bun sign as suspected.