[Brown syndrome: clinical and radiological correlation]

Area of Science:

• Ophthalmology
• Medical Imaging
• Anatomy

Background:

• Brown syndrome presents with limited elevation in adduction, stemming from complex interactions between the superior oblique muscle, its tendon, and the trochlea.
• Understanding the precise anatomical mechanisms is crucial for effective diagnosis and management.

Purpose of the Study:

• To investigate the underlying anatomical mechanisms of Brown syndrome using magnetic resonance (MR) imaging.
• To differentiate between congenital and acquired forms of Brown syndrome based on imaging findings.

Main Methods:

• A retrospective case series of 14 patients (10 congenital, 4 acquired) with unilateral Brown syndrome.
• Ophthalmic and orthoptic evaluations were performed.
• MR imaging utilized 3D-FIESTA sequences for ocular motor nerves and FSE T1, T2WI with surface coils for orbits.

Main Results:

• Congenital Brown syndrome cases (9/10) showed superior oblique (SO) hypoplasia.
• Acquired cases (3/4) exhibited trochlear fracture, scarring, and superior orbital fracture, often linked to trauma.
• One acquired case displayed SO scarring and hypoplasia.

Conclusions:

• Brown syndrome encompasses a spectrum of conditions with diverse anatomical underpinnings despite similar clinical presentations.
• Management strategies for Brown syndrome should be tailored to the specific pathophysiology of each patient.