Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Dec 30;16(3):604-606.
doi: 10.1016/j.radcr.2020.12.058. eCollection 2021 Mar.

Intracranial migration of intraocular silicone oil mimicking metastatic disease

Nurahmed Mohammed  1 , Daniel Urbine  1
Affiliations
Case Reports

Intracranial migration of intraocular silicone oil mimicking metastatic disease

Nurahmed Mohammed et al. Radiol Case Rep. .

Abstract

Silicone oil (SO) is a commonly used agent of intraocular endotamponade for treating complicated retinal detachment. We report a case of SO migration into the cerebral ventricles which was initially misdiagnosed as metastatic disease. Misinterpretation of SO as metastatic disease in a patient with a lung nodule triggered admission to a medical intensive care unit and unnecessary evaluation with further imaging and invasive procedures.

Keywords: Intracranial hemorrhage; Intracranial silicone; Intraocular silicone; Intraventricular hemorrhage; Retinal detachment.

PubMed Disclaimer

Conflict of interest statement

I have no conflict of interest.

Figures

Fig 1
Fig. 1
(A) Axial CT scan of the head at the level of the eyes showing changes from a right eye evisceration and acrylic conformer insertion in the past and an ovoid hyperdensity in the left globe that corresponds to intraocular silicone oil, which was used to endotamponade a previous retinal detachment. (B) Axial CT scan of the head at the level of the lateral ventricles showing 2 ovoid hyperdensities in the frontal horns bilaterally. The hyperdensities are located anteriorly, because the patient is supine, and the silicone oil has lower density than the cerebrospinal fluid.
Fig 2
Fig. 2
(A) Axial T1-weighted MRI at the level of the eyes showing again the previously performed right eye evisceration and acrylic conformer insertion, and an ovoid-shaped isointense signal in the left globe that corresponds to intraocular silicone oil and has the same signal signature with fat. (B) Axial T1-weighted MRI at the level of the lateral ventricles showing 2 ovoid hyperdensities in the frontal horns bilaterally.
Fig 3
Fig. 3
PET scan shows a 13 mm spiculated right lower lobe nodule with low FDG uptake.
Fig 4
Fig. 4
Prone head NCCT shows the hyperattenuating substance located in the occipital horns of the lateral ventricles moved from a gravity nondependent location to another gravity nondependent, which confirms the relative lower specific gravity of the hyperattenuating substance, consistent with silicone oil.
See this image and copyright information in PMC

References

    1. Riedel KG, Gabel VP, Neubauer L, Kampik A, Lund OE. Intravitreal silicone oil injection: complications and treatment of 415 consecutive patients. Graefes Arch Clin Exp Ophthalmol Albrecht Von Graefes Arch Klin Exp Ophthalmol. 1990;228(1):19–23. doi: 10.1007/bf02764284. - DOI - PubMed
    1. Hruby PM, Poley PR, Terp PA, Thorell WE, Margalit E. Headaches secondary to intraventricular silicone oil successfully managed with ventriculoperitoneal shunt. Retin Cases Brief Rep. 2013;7(3):288–290. doi: 10.1097/ICB.0b013e31828eeffe. - DOI - PubMed
    1. Williams RL, Beatty RL, Kanal E, Weissman JL. MR imaging of intraventricular silicone: case report. Radiology. 1999;212:151–154. - PubMed
    1. Herrick RC, Hayman LA, Maturi RK, DiazMarchan PJ, Tang RA, Lambert HM. Optimal imaging protocol after intraocular silicone oil tamponade. AJNR Am J Neuroradiol. 1998;19:101–108. - PMC - PubMed
    1. Mathews VP, Elster AD, Barker PB, Buff BL, Haller JA, Greven CM. Intraocular silicone oil: in vitro and in vivo MR and CT characteristics. AJNR Am J Neuroradiol. 1994;15:343–347. - PMC - PubMed

Publication types

LinkOut - more resources