The "hot cross bun" sign is a rare radiologic sign seen on magnetic resonance imaging that can help direct the diagnosis of the cerebellar subtype of multiple system atrophy. It indicates damage to the transverse pontocerebellar fibers and can be seen in other pathologies including spinocerebellar ataxia. The name for this radiologic sign was coined in 1998, likening the cruciform hyperintensity on imaging to the English spiced bun marked with a cross and historically eaten on the Christian religious holiday Good Friday.
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