Presentation
Left Brown syndrome with pain.
Patient Data
Marked thickening and enhancement of the left superior oblique tendon sheath at and distal to the trochlea, extending to the globe insertion. Associated mild edema-like signal.
No intra-orbital or intracranial mass otherwise.
Confluent cerebral white matter bright FLAIR signal commonly represent moderate chronic microangiopathic gliosis.
Paranasal sinuses are clear. No other significant intracranial or intra-orbital pathology seen.
Case Discussion
This is a case of Brown syndrome, diagnosed clinically by the referring ophthalmologist. MRI has demonstrated marked thickening and enhancement of the left superior oblique tendon sheath complex, extending from the trochlea to its globe insertion, but the cause of this is not known.
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