PMC7303758_01
MRI brain (T2 axial section). Extensive postcontrast T2 FLAIR enhancement of periventricular and cerebellar diseases with patchy leptomeningeal enhancement accentuated by the FLAIR technique. (a) Large T2 FLAIR signal in the body of corpus (snowball lesions) and throughout the periventricular white matter. (b) Regions of T2 FLAIR signal correlated with DWI (b1000) diffusion restriction.
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fig1
Fundal photography (right eye) showing a ghost vessel, likely secondary to previous branch retinal artery occlusion (arrow) (a). Late-phase fundal angiography with no perfusion noted in the corresponding territory (b).
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The patient developed painless scotomata, and a branch retinal artery occlusion (BRAO) of the right temporal retina was identified on fundal photography and retinal fluorescein angiography (Figure 2).
Timeline of case presentation with relapses and treatment moldalities.
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fig3
A further clinical relapse occurred 3 months later, i.e., 14 months (Figure 3) after initial treatment was commenced, characterized by sudden painless partial visual loss in the right eye with new BRAO encroaching on the central retina, persisting hearing loss, and MRI changes demonstrating diffuse cerebellar, leptomeningeal, and parenchymal enhancement.