A Case of Traumatic Medial Longitudinal Fasciculus Syndrome Whose Causal Lesion Was Detected by Thin-Section MRI with Susceptibility-Weighted Imaging

Abstract

The aim of the study was to report a case of traumatic medial longitudinal fasciculus (MLF) syndrome diagnosed with brain magnetic resonance imaging (MRI) after a head injury. A 71-year-old male complained of diplopia after he was bruised the back of his head when he was hit by a bicycle and fell down. He showed failure of adduction in the right eye, and mild nystagmus was found in the left eye when looking to the left. Convergence was intact. A low-intensity area was found at the middle right site in the lower part of the midbrain using thin-section MRI with susceptibility-weighted imaging (SWI), which suggested a hemorrhage. From the present history, characteristic abnormality of eye movement, and MRI imaging, he was diagnosed with traumatic MLF syndrome. His symptom was resolved, and the eye movement was improved in 2 weeks. A hemorrhage that occurs in the brainstem may be a cause of traumatic MLF syndrome which could be detected by thin-slice MRI with SWI.

Keywords

• medial longitudinal fasciculus syndrome
• trauma
• magnetic resonance imaging
• susceptibility-weighted imaging