Migration of silicone oil in the cerebral intraventricular system

Abstract

Objective and importance: Silicone oil is commonly used to tamponade the retina in the case of retinal detachment. We present a case in which silicone oils had migrated to the ventricles and the head computed tomographic (CT) scan was misread as intraventricular hemorrhage.

Clinical presentation: We report a 72-year-old patient who was referred to us with the diagnosis of subarachnoid hemorrhage associated with intraventricular hemorrhage based on a head CT done in the emergency room for increased headaches.

Intervention: The density of the silicone oil on CT mimicked the density of blood and led to the initial misinterpretation of the head CT. A brain magnetic resonance imaging was done and confirmed the diagnosis of silicone oil that migrated from the eye to the subarachnoid space and intraventricular space.

Conclusion: The possibility of the silicone oil causing chemical meningitis and possible hydrocephalus was raised, but the patient's headaches improved and it was decided not to pursue any further diagnostic work up.