BRAIN and NERVE Shinkei Kenkyu no Shinpo Volume 70, Issue 12 (December 2018)

Diplopia/Double Vision Harushi Mori 1 1Department of Radiology, Graduate School and Faculty of Medicine, the University of Tokyo Keyword: 複視 , 眼球運動障害 , 年齢 , 発症様式 , 症候群 , diplopia , eye movement disorder , age , onset , syndrome pp.1349-1358
Published Date 2018/12/1
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Here, I review the efficacy of radiological methods in the diagnosis of diplopia/double vision. The simplest technique for achieving a successful diagnosis is to capture a wide field-of-view image. In order to start the process of diagnosis, it is fundamental to first study the image findings. Analysis based on the principle of MECE or mutually exclusive collectively exhaustive is performed using four methods: deductive reasoning, fractionation, longitudinal study, and priority setting. The conventional practical procedure to attain a diagnosis is as follows. First, identify the location of the lesion by imaging, which will shorten the list of differential diagnosis. Second, obtain as much information as possible on the characteristics of the lesion in order to determine the pathology. Third, look for any associated findings, such as tortuous vasculature around the brain. Fourth, refer to all the available information; for example, the main complaint, clinical history, previous history, family history, physical findings, physiological findings, laboratory data, previous images, and other modalities. Finally, if still in doubt, one should consult with colleagues and the attending physician. However, because rationality (statistical analyses, such as posterior probability or positive predictive value with positive findings), predicted utility, and emotions play a factor in a person's decision making, it seems impossible to completely avoid oversights and misdiagnosis.

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BRAIN and NERVE-神経研究の進歩
70巻12号 (2018年12月)
電子版ISSN 1344-8129 印刷版ISSN 1881-6096 医学書院