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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)
To characterize and demonstrate structural abnormalities in the rare instance of acquired Brown's syndrome in children.
Retrospective chart review of pediatric patients with the diagnosis of non- congenital Brown's syndrome. Blinded re-evaluation of available MR imaging was performed.
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.
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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