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Medicine Stroke and TIA 992aad73

An 18-year-old woman is referred to your clinic after branch retinal aery occlusions occurred in each eye several months apa. Examination reveals moderate hearing loss in the right ear, in addition to visual field loss in each eye. A brain MRI reveals multiple small coical strokes in the frontal lobes and the left parietal lobe. Which of the following diagnosis fits best with this clinical presentation?

A
Multiple sclerosis
B
Susac syndrome
C
Acute disseminated encephalomyelitis
D
Conversion reaction
High-Yield Explanation
Whenever multi-system involvement, vasculitis can be the cause (here in the question moderate hearing loss, visual field loss, multiple coical strokes so vasculitis can be the cause) Option A- Presents with OPTIC NEURITIS, doesn't involve the Retinal circulation and hearing. Option B- Susac syndrome is a type of vasculitis involving BRAIN, EYE, EAR Option C- It is a complication of vaccines e.g. RABIES vaccine. Susac syndrome Characterized by three main problems: Impaired brain function (encephalopathy) Paial or complete blockage (occlusion) of the small aeries and capillaries that supply blood to the retina ( BRAO) Inner ear disease (hearing loss, most notably). MRI of the brain typically reveals "snowball" lesions in the corpus.

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