case_images: PMC2939431_01
case_images: MRI imaging's showing the reported alterations. (A) Hot cross sign. (B1) cerebellar and (B2) pons atrophy. (C) Atrophy of middle cerebellum peduncles.
case_images: CRM2010-351239.001.jpg
case_images: PMC2939431_01_CRM2010-351239.001.jpg
case_images: fig1
case_images: In order to screen the Central Nervous System for disorders like ischemic disease, a Brain Magnetic Resonance Imaging was performed and disclosed atrophy of middle cerebellar peduncles and pons with the "hot cross bun sign" (Figure 1). Imaging findings associated with the presence of the clinical criteria like cerebellar ataxia, limb ataxia, orthostatic blood pressure decline, and stridor are compatible with Multiple-System
case_images: Vocal cords paralysis reported in endoscopy.
case_images: CRM2010-351239.002.jpg
case_images: PMC2939431_01_CRM2010-351239.002.jpg
case_images: fig2
case_images: Atrophy with cerebellar predominance (MSA-c). A new reasessement in Otolaryngology still disclosed vocal cords paralysis (Figure 2) and tracheostomy was kept permanently.