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Cerebrotendinous xanthomatosis in a 44-year-old Indian man (MRI)

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FLAIR axials (A, C), coronal (B), and T2 axial (D) show symmetric hyperintensities in periventricular white matter, corticospinal tracts, middle cerebellar peduncle, dentate and peri-dentate white matter, and inferior olives. “Hot cross bun” sign can be seen within pons (C). Susceptibility-weighted imaging (E) shows blooming in dentate nuclei. Long-segment hyperintensity of dorsal and lateral columns is seen in the axial (F, G) and sagittal (H) T2 sequences of the spine MRI. (Source: Katragadda P, Holla VV, Kamble N, Saini J, Yadav R, Pal PK. Clinical and imaging profile of patients with cerebrotendinous xanthomatosis: a video case series from India. Tremor Other Hyperkinet Mov [N Y] 2024;14:10. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)