case_images: PMC4101947_01
case_images: Day 1.
case_images: CRIRH2014-582094.001.jpg
case_images: PMC4101947_01_CRIRH2014-582094.001.jpg
case_images: fig1
case_images: Clinical examination revealed left eye ecchymosis, hemorrhagic chemosis, unilateral proptosis, with no evidence of uveitis, and normal fundus (see Figures 1(a) and 1(b)).
case_images: (a) Day 3. (b) Day 4.
case_images: CRIRH2014-582094.002.jpg
case_images: PMC4101947_01_CRIRH2014-582094.002.jpg
case_images: fig2
case_images: A repeat MRI brain showed an interval development of multifocal deep gray nuclei signal abnormalities including diffusion restriction in the caudate nuclei, right globus pallidus, and posterior limb of the internal capsule (see Figure 2(a)). His subsequent MRI brain showed further progression of lesions involving the caudate nuclei, thalami, striatum, and brainstem with new areas of hemorrhage and enhancement (Figure 2(b)).
case_images: Brain biopsy.
case_images: CRIRH2014-582094.003.jpg
case_images: PMC4101947_01_CRIRH2014-582094.003.jpg
case_images: fig3
case_images: The brain biopsy showed necrotizing vasculitis (Figure 3) with no evidence of granuloma.