Brown syndrome is a rare form of strabismus characterized by limitation of elevation of the eyeball on adduction. In Brown syndrome, which is mostly congenital but sometimes may be acquired, the major problem is the lack of relaxation of the superior oblique muscle in elevation on adduction. Short superior oblique tendon sheath, short superior oblique tendon, abnormalities that limit the movement of the superior oblique tendon at the tendon-trochlea complex and the developmental abnormalities of 4th nerve are the possible etiological factors in congenital group....

These case series constitutes of 3 patients in pediatric age group with the diagnosis of acquired Brown syndrome. All MRI studies were done on a 1.5T MR unit (Philips Achieva 1.5T, The Netherlands), with a flexible small parts coil or neurovascular coil used interchangeable. The patients were sedated when necessary.

Case 1: A 7-years-old-boy had developed Brown syndrome on his left eye, following a Valsalva maneuver during a circumcision procedure under local anesthesia (Figure 1). The MRI study, that was held approximately 2 weeks after the onset of the symptoms revealed enlargement of tendon-trochlea complex on the right side. The tendon-trochlea complex showed some high signals on T1 weighted images, which was attributed to a possible hemorrhage (Figure 2). The patient was treated conservatively and the symptoms resolved spontaneously (Figure 3). Case 2: A 12-years-old...

The presented 3 cases of acquired Brown syndrome demonstrate that the same clinical findings may be related to different unrelated etiological problems. MRI has a significant role to find out the underlying cause of acquired Brown syndrome and allows the clinician to make an appropriate plan for treatment.

First and third authors are from the Radiology Department, second and forth authors are from Ophthalmology Department of Adnan Menderes University, Faculty of Medicine, Aydın/TURKEY

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