Intraventricular silicone oil

Case report

Restricted access

The authors report a case in which intravitreous silicone oil migrated into the ventricles. They note that intraventricular silicone oil can be misdiagnosed as intraventricular hemorrhage and neurosurgeons should be aware of this possibility.

This 58-year-old woman with a history of Type II diabetic mellitus and retinal detachment (resulting from diabetic retinopathy), which had been treated with intravitreous silicone tamponade, presented with dizziness and headache approximately 10 years after the intravitreous silicone treatment. Over the next 6 years she underwent 2 non–contrast-enhanced brain CT studies and 1 MRI study for evaluation of her symptoms. On CT scan, extension of the intraocular silicone along the optic nerve was evident. Two hyperdense nodules were observed freely floating in the right lateral and fourth ventricles, remaining in the nondependent portion of ventricles in both supine and prone positions. On T2-weighted MRI, the left orbital content and the intraventricular nodules all demonstrated chemical shift artifacts typically associated with silicone. The imaging findings were characteristic for intraventricular silicone after silicone oil tamponade. The patient's dizziness and headache were treated symptomatically and she was followed up at the outpatient department.

Migration of intravitreous silicone oil into the cerebral ventricles is a rare complication. Intraventricular silicone oil can mimic intraventricular hemorrhage. Radiographically, intraventricular silicone oil can be distinguished from hemorrhage as silicone oil tends to stay in the nondependent portion of the ventricle. Chemical shift artifacts on MRI may help establishing the diagnosis of intraventricular silicone oil. Currently, there is no consensus on surgical removal of intraventricular silicone oil, and in the majority of cases reported in the literature, the patients were asymptomatic.

Article Information

Contributor Notes

Address correspondence to: Cheng Hong Toh, M.D., Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Chang Gung University, 5 Fu hsing Street, Kwei-Shan, Taoyuan, Taiwan (333). email: include this information when citing this paper: published online January 25, 2013; DOI: 10.3171/2013.1.JNS121570.
  • 1

    Fangtian DRongping DLin ZWeihong Y: Migration of intraocular silicone into the cerebral ventricles. Am J Ophthalmol 140:1561582005

    • Search Google Scholar
    • Export Citation
  • 2

    Kiilgaard JFMilea DLøgager Vla Cour M: Cerebral migration of intraocular silicone oil: an MRI study. Acta Ophthalmol 89:5225252011

    • Search Google Scholar
    • Export Citation
  • 3

    Murray JGGean ADBarr RM: Intraocular silicone oil for retinal detachment in AIDS: CT and MR appearances. Clin Radiol 51:4154171996

    • Search Google Scholar
    • Export Citation
  • 4

    Shields CLEagle RC Jr: Pseudo-Schnabel's cavernous degeneration of the optic nerve secondary to intraocular silicone oil. Arch Ophthalmol 107:7147171989

    • Search Google Scholar
    • Export Citation
  • 5

    Tatewaki YKurihara NSato ASuzuki IEzura MTakahashi S: Silicone oil migrating from intraocular tamponade into the ventricles: case report with magnetic resonance image findings. J Comput Assist Tomogr 35:43452011

    • Search Google Scholar
    • Export Citation
  • 6

    Williams RLBeatty RLKanal EWeissman JL: MR imaging of intraventricular silicone: case report. Radiology 212:1511541999

  • 7

    Yu JTApte RS: A case of intravitreal silicone oil migration to the central nervous system. Retina 25:7917932005



All Time Past Year Past 30 Days
Abstract Views 338 307 22
Full Text Views 236 94 5
PDF Downloads 144 44 5
EPUB Downloads 0 0 0
Google Scholar