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[Traumatic bilateral MLF syndrome--a case report]

T Kuroiwa1, H Tanabe, H Takatsuka

  • 1Department of Neurosurgery, Osaka Mishima Critical Care Medical Center, Japan.

No to Shinkei = Brain and Nerve
|April 1, 1993
PubMed
Summary

Traumatic brain injury can cause bilateral medial longitudinal fasciculus (MLF) syndrome. This case report details a patient who recovered fully from this rare neurological condition following a severe head injury.

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Area of Science:

  • Neuroscience
  • Neurology
  • Trauma Surgery

Background:

  • The medial longitudinal fasciculus (MLF) is a crucial bilateral white matter tract connecting cranial nerve nuclei involved in conjugate eye movement.
  • Bilateral MLF syndrome is a rare neurological condition characterized by impaired eye movements, often resulting from brainstem lesions.

Observation:

  • An 18-year-old male sustained a severe head injury from a traffic accident, presenting with altered consciousness and diagnosed with a left occipital skull fracture.
  • Initial CT scans revealed extensive intracranial injuries including subdural hematoma, contusions, subarachnoid hemorrhage, and pneumocephalus.
  • Two weeks post-injury, the patient developed symptoms consistent with bilateral MLF syndrome.

Findings:

  • The patient was diagnosed with bilateral medial longitudinal fasciculus (MLF) syndrome following traumatic brain injury.

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  • Treatment included management of intracranial hemorrhage with barbiturates, dehydration, and steroids.
  • The patient demonstrated significant improvement in MLF syndrome symptoms within one month.

    • Implications:

    • This case highlights that traumatic brain injury, even without direct brainstem impact, can lead to bilateral MLF syndrome.
    • Prompt diagnosis and management of associated intracranial pathologies are crucial for neurological recovery.
    • Full recovery from traumatic bilateral MLF syndrome is possible, emphasizing the importance of comprehensive patient care.