title: MRI findings in Susac's syndrome.
abstract: BACKGROUND
  Susac syndrome (SS) is a self-limited syndrome, presumably autoimmune, consisting of a clinical triad of encephalopathy, branch retinal artery occlusions, and hearing loss. All three elements of the triad may not be present or recognized, and MR imaging is often necessary to establish the diagnosis.
  
  
  OBJECTIVE
  To determine the spectrum of abnormalities on MRI in SS.
  
  
  METHODS
  The authors reviewed the MR images of 27 previously unreported patients with the clinical SS triad, and 51 patients from published articles in which the MR images were depicted or reported.
  
  
  RESULTS
  All 27 patients had multifocal supratentorial white matter lesions including the corpus callosum. The deep gray nuclei (basal ganglia and thalamus) were involved in 19 (70%). Nineteen (70%) also had parenchymal enhancement and 9 (33%) had leptomeningeal enhancement. Of the 51 cases from the literature, at least 32 had callosal lesions. The authors could not determine the presence of callosal lesions in 18 of these patients, and only one was reported to have a normal MRI at the onset of encephalopathy.
  
  
  CONCLUSIONS
  The MR scans in SS show a rather distinctive pattern of supratentorial white matter lesions that always involve the corpus callosum. There is often deep gray matter, posterior fossa involvement, and frequent parenchymal with occasional leptomeningeal enhancement. The central callosal lesions differ from those in demyelinating disease, and should support the diagnosis of SS in patients with at least two of the three features of the clinical triad.
authors.affiliation: Neurology and Neurosurgery Associates, Winter Haven, FL 33880, USA. jsusac@neurohaven.com
authors.forename: J O
authors.initials: JO
authors.lastname: Susac
authors.forename: F R
authors.initials: FR
authors.lastname: Murtagh
authors.forename: R A
authors.initials: RA
authors.lastname: Egan
authors.forename: J R
authors.initials: JR
authors.lastname: Berger
authors.forename: R
authors.initials: R
authors.lastname: Bakshi
authors.forename: N
authors.initials: N
authors.lastname: Lincoff
authors.forename: A D
authors.initials: AD
authors.lastname: Gean
authors.forename: S L
authors.initials: SL
authors.lastname: Galetta
authors.forename: R J
authors.initials: RJ
authors.lastname: Fox
authors.forename: F E
authors.initials: FE
authors.lastname: Costello
authors.forename: A G
authors.initials: AG
authors.lastname: Lee
authors.forename: J
authors.initials: J
authors.lastname: Clark
authors.forename: R B
authors.initials: RB
authors.lastname: Layzer
authors.forename: R B
authors.initials: RB
authors.lastname: Daroff
mesh_terms: D000328:Adult; D020274:Autoimmune Diseases of the Nervous System / Q000150:complications / Q000175:diagnosis*; D001479:Basal Ganglia / Q000473:pathology; D001921:Brain / Q000473:pathology; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis*; D003337:Corpus Callosum / Q000473:pathology; D005260:Female; D005682:Gadolinium; D034381:Hearing Loss / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015356:Retinal Artery Occlusion / Q000150:complications / Q000175:diagnosis*; D013577:Syndrome; D013788:Thalamus / Q000473:pathology
chemical_list: D005682:Gadolinium