PMC4101947_01
Day 1.
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fig1
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)).
(a) Day 3. (b) Day 4.
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fig2
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)).
Brain biopsy.
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fig3
The brain biopsy showed necrotizing vasculitis (Figure 3) with no evidence of granuloma.