2021 Volume 26 Issue 1 Pages 111-117
Cases of medial longitudinal fasciculus (MLF) syndrome caused by head trauma are occasionally reported. Cases that are classified as mild may be caused by falls or traffic accidents, and they are often accompanied by temporary loss of consciousness. We report a case of MLF syndrome caused by a trivial head trauma. A 61-year-old man was admitted to our hospital because of nausea, unsteady gait, and diplopia that appeared after he sustained a bruise on the forehead after accidently walking into a pillar. Based on head computed tomography (CT) and magnetic resonance imaging (MRI) findings, a diagnosis of acute infarction of the left pons and traumatic subarachnoid hemorrhage in the interpeduncular cistern was established. The patient was conservatively treated. The bleeding did not spread and the symptoms were relieved. Eventually, there was only a slight adduction disorder and he was discharged 15 days after the injury. In this case, the impact of the head injury caused traction of the perforator branch of the basilar artery, resulting in a subarachnoid hemorrhage in the interpeduncular cistern; the MLF syndrome was thus considered to be ischemic.
