PMC9437433_01
Brain MRI of our patient showing progressive atrophy of the cerebellum and the middle cerebellar peduncle. The hot cross bun sign and the abnormal signal in the middle cerebellar peduncles became more pronounced over time.
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F1
T2 hyperintensity in the middle of the pons (Figure 1). There was no improvement with pulse glucocorticoid therapy and intravenous immunoglobulin, and she developed slurred speech and dysphagia. HCBs, with signal change in the bilateral middle cerebellar peduncles and widened cerebellar sulci (Figure 1).
The timeline of the present case.
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F2
The clinical course of the patient is summarized in Figure 2.