Differential diagnosis of hot cross bun sign

@article{Rissardo2019DifferentialDO,
  title={Differential diagnosis of hot cross bun sign},
  author={J. Rissardo and Ana Let{\'i}cia Fornari Caprara},
  journal={Archives of Medicine and Health Sciences},
  year={2019},
  volume={7},
  pages={131 - 133}
}
Multiple system atrophy (MSA) is a term that represents a group of neurodegenerative diseases characterized by different levels of autonomic, cerebellar, parkinsonism, and pyramidal features. Hereinafter, we report a case of an elderly male who presented to our hospital with progressive gait instability and slurred speech. On examination, an orthostatic decrease of blood pressure of standing was observed. The neurological examination showed cerebellar signs and symptoms. A brain magnetic… 
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References

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The hot cross bun sign in a patient with encephalitis
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TLDR
There were bilateral cerebellar hypointensities involving dentate nuclei on T1-weighted images with corresponding hyperintensities on T2- Weighted MRI, and an interesting MRI finding—‘hot cross bun’ appearance was seen in pons which has not been reported in the literature so far.
The ‘Hot Cross Bun’ Sign Is Not Always Multiple System Atrophy: Etiologies of 11 Cases
TLDR
The specificity of the ‘hot cross bun’ sign (HCBS) for multiple system atrophy (MSA) in adult cerebellar ataxia or parkinsonism is clarified to clarify the most common etiology.
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TLDR
Interestingly, the patient presented with atrophy of the cerebellum and brainstem, and exhibited typical “hot cross bun” sign in the pons, which are most often observed in patients with MSA, which was identified by finding malignant melanoma cells in CSF.
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TLDR
A rare case of the HCB sign in an adult female patient with leptomeningeal metastases of breast cancer without any signs of brain atrophy is described, though the underlying mechanisms remain unknown.
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