Monday, March 11, 2013

Holes

This patient presented with vision loss, hearing loss, and a gradual confusion. The visual loss is monocular, restricted just to part of the visual field. Fundoscopic examination shows a sectoral pattern of retinal opacification. A T1 MRI is shown above.

Challenge: What's the rare diagnosis?

Image is in the public domain.

2 comments:

Alex said...

confused. thought this was a t1 hypointense callososeptal lesion c/w MS. but can't account for the sx and the "rare" diagnosis.

Craig Chen said...

yes - callososeptal lesions, but happens to be susac syndrome, not MS
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Holes

Susac syndrome is associated with a clinical triad of branch retinal artery occlusions, sensorineural hearing loss, and subacute encephalopathy. The sagittal T1 MRI shows pathognomonic central callosal holes representing microinfarcts.

Sources: openi.nlm.nih.gov; UpToDate.