Case report: Susac syndrome-two ends of the spectrum, single center case reports and review of the literature

Front Neurol. 2024 Feb 16:15:1339438. doi: 10.3389/fneur.2024.1339438. eCollection 2024.

Abstract

Susac syndrome is a rare and enigmatic complex neurological disorder primarily affecting small blood vessels in the brain, retina, and inner ear. Diagnosing Susac syndrome may be extremely challenging not only due to its rarity, but also due to the variability of its clinical presentation. This paper describes two vastly different cases-one with mild symptoms and good response to therapy, the other with severe, complicated course, relapses and long-term sequelae despite multiple therapeutic interventions. Building upon the available guidelines, we highlight the utility of black blood MRI in this disease and provide a comprehensive review of available clinical experience in clinical presentation, diagnosis and therapy of this disease. Despite its rarity, the awareness of Susac syndrome may be of uttermost importance since it ultimately is a treatable condition. If diagnosed in a timely manner, early intervention can substantially improve the outcomes of our patients.

Keywords: Susac syndrome; black blood imaging; branch retinal arterial occlusion; hearing loss; neuroimmunology; stroke; vasculitis.

Publication types

  • Case Reports

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. RH was supported by the Ministry of Health of the Czech Republic (Grant No. DRO–UHHK 00179906). RH and VW were supported by Charles University, Czech Republic (Cooperation Program, research area NEUR).