PMC3903029_01
SS findings on MRI brain (A, B), fundus photographs (C) and fundus angiography (D). A. T1-weighted MRI brain showing punched out lesions in the corpus callosum (arrowed) typical of Susac's syndrome. B. Axial T2- weighted MRI brain showing typical "snow ball" appearance of inflammation in the posterior corpus callosum (arrow) C. Colour fundus photograph showing branch retinal artery occlusion (arrowed) in the peripheral fundus (OS). D. Fundus fluorescein angiographic image showing the same lesion (broken arrow) and additional occlusions not previously recognised on clinical examination alone (unbroken arrows).
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A T1-weighted brain MRI revealed inflammatory changes, with multiple 'punched-out' lesions in the corpus callosum (Figure 1A). T2- weighted MRI "snow ball" appearance of inflammation in the posterior corpus callosum was found (Figure 1B). These features were identified as being suggestive of SS, and thus an ophthalmology opinion was sought. Dilated fundal examination revealed healthy discs and maculae but multiple BRAO bilaterally (Figure 1C), which were found to be even more widespread on fluorescein angiography (Figure 1D).