The hot cross bun sign in a patient with encephalitis

The 'hot cross' bun (HCB) sign refers to pontine cruciform hyperintensity on T2 weighted magnetic resonance image (MRI) which is frequently seen in multiple system atrophy and spinocerebellar ataxia types 2 and 3. We describe a 3 years old boy of encephalitis and his MRI image showed HCB sign in the pontine. After immunosuppressive treatment and followed up 14 months, he got a good outcome and the HCB sign narrowed nearly disappeared.