Hot cross bun sign (pons)

Last revised by Rohit Sharma on 30 Jan 2024

The hot cross bun sign refers to the MRI appearance of the pons when T2 hyperintensity forms a cross on axial images, representing selective degeneration of transverse pontocerebellar tracts and median pontine raphe nuclei 1.

It has been described in a variety of neurodegenerative and other conditions. Common associations include:

Other causes which are either very rare or in which presence of the sign is rarely reported include 17:

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