Clinical Snapshot
Migration of Intravitreal Silicone Oil Into the Lateral Cerebral Ventricles
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An 83-year-old male patient with impaired speech underwent native cranial computed tomography (CT) to exclude a stroke. CT showed two indeterminate round structures in both frontal horns of the lateral ventricles that presented as intraventricular blood based on their CT density (arrows in Figue a), but were located at the top rather than at the bottom of the ventricle. Closer scrutiny of the patient’s medical history revealed an instance of retinal detachment of the right eye. This had been treated approximately 2 years previously with intravitreal silicone oil tamponade during retinal surgery. To confirm the suspected diagnosis of an extremely rare migration of intravitreal silicone oil (along the optic nerve) into the subarachnoid space and extending as far as the intraventricular space, a CT scan in the prone position and additional magnetic resonance imaging were performed. In the prone position, the structures rose on both sides into the posterior horns of the lateral ventricles (Figure b). Thus, intracranial hemorrhage could be excluded and the suspected diagnosis of intracranial silicone migration confirmed. Most patients exhibit no clinical symptoms. In rare cases, intraventricular silicone may block the flow of cerebrospinal fluid.
Acknowledgments: We would like to thank Prof. Dr. med. Philipp S. Müther (MVZ OculAix Augenheilkunde Aachen GmbH) for revising the case study from an ophthalmic/ophthalmic surgery perspective.
Dr. med. Ehsan Yousefian Jazi, Dr. med. Anne Wegerhof, Dr. med. Farahnaz Haddadi, Rhein-Maas-Klinikum, Radiologie und Neuroradiologie, Würselen
ehsan.yousefianjazi@rheinmaasklinikum.de
Conflict of interest statement: The authors state that no conflict of interest exists.
Translated from the original German by Christine Rye.
Cite this as: Yousefian Jazi E, Wegerhof A, Haddadi F: Migration of intravitreal silicone oil into the lateral cerebral ventricles. Dtsch Arztebl Int 2025; 122: 224. DOI: 10.3238/arztebl.m2024.0136
Klinik für Radiologie, Rhein-Maas-Klinikum, Würselen
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