Susac Syndrome

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  A patient experienced one week of flu-like symptoms and severe headache, followed by acute left inferior quadrantanopia. She was diagnosed with a BRAO, and Brain MRI revealed multifocal infarcts of the white matter. No source of emboli was found, and the patient was discharged on dual antiplatelet therapy. Several weeks later, she represented with new headache, worsening scotomas in both eyes, and right sided hearing loss. A second MRI was positive for corpus callosum white matter lesions. Macular OCT revealed left sided BRAO. Fundus autofluorescence demonstrated arterial wall hyperfluorescence in both eyes. Given the triad of branch retinal artery occlusion, hearing loss, and neurological symptoms with characteristic MRI findings, a diagnosis of Susac Sundrome was made. The patient was started on Rituximab, solumedrol and IVIG. At follow up, the patients right eye symptoms resolved, left eye scotoma remained stable, and she maintains her 20/20 visual acuity.
  

  Presentation Date: 04/16/2026
  Issue Date: 04/24/2026
  

  • Select activity Presenter: Kisha Kalra, MD

    

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  • Select activity Faculty Discussant: Thomas A. Albini, MD

    

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