June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Acquired Brown’s Syndrome in children: MRI abnormalities of the superior oblique tendon-trochlea complex
Author Affiliations & Notes
  • Christina Gerth-Kahlert
    Ophthalmology, University Hospital Zurich, Zurich, Switzerland
  • Veit Sturm
    Ophthalmology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
  • Werner Wichmann
    Neuroradiology, University Hospital, Zurich, Switzerland
  • Footnotes
    Commercial Relationships Christina Gerth-Kahlert, None; Veit Sturm, None; Werner Wichmann, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 5229. doi:
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      Christina Gerth-Kahlert, Veit Sturm, Werner Wichmann; Acquired Brown’s Syndrome in children: MRI abnormalities of the superior oblique tendon-trochlea complex. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5229.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To characterize and demonstrate structural abnormalities in the rare instance of acquired Brown's syndrome in children.

Methods: Retrospective chart review of pediatric patients with the diagnosis of non- congenital Brown's syndrome. Blinded re-evaluation of available MR imaging was performed.

Results: Three patients (2 female, 1 male) with an age at onset of first symptoms of 6.2, 8.2 and 8.5 years were identified. Signs and symptoms at onset were diplopia, abnormal head posture (AHP) and strabismus. 2/3 children had a documented normal orthoptic examination prior to the acute onset of vertical strabismus. All children lacked other neurological signs. MRI performed between 10 days and 8 weeks after first diagnosis showed contrast enhancement of the superior oblique tendon in 2/3 and thickening in the area of the trochlea- tendon complex in 2/3 cases. Clinical follow up demonstrated improved motility with consecutive reduction of diplopia and extent of AHP in 2/3 cases after 0.4 to 1.4 years.

Conclusions: Acquired Brown’s syndrome might be caused by a localized inflammation of the superior oblique tendon/ trochlea complex. Despite the good clinical outcome, MR imaging in patients with an acute onset is recommended to exclude other etiologies.


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