Matthew B Potts1, Alex C Wu2, David J Rusinak2, Kartik Kesavabhotla3, Babak S Jahromi4. 1. Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. Electronic address: matthew.potts@nm.org. 2. Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 3. Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. 4. Department of Neurological Surgery, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Radiology, Northwestern Memorial Hospital, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
Abstract
BACKGROUND: Intraocular injection of silicone oil is commonly performed during vitrectomy to tamponade the retina in place for treatment of retinal detachment. Although rare, this intravitreal silicone can migrate through the optic nerve and chiasm and enter the cerebral ventricles. CASE DESCRIPTION: Here we present a case report of a patient presenting with headache and intraventricular hyperdensities on a computed tomography (CT) scan, raising a concern for intraventricular hemorrhage. However, the intraventricular hyperdensities were in a nondependent location and moved to a new nondependent location when repeat imaging was performed with the patient in the prone position. We provide a literature review of this phenomenon and discuss the relevant CT and magnetic resonance imaging findings. CONCLUSIONS: Intraocular silicone can rarely migrate into the cerebral ventricular system. Careful review of the clinical history and imaging findings can help distinguish this from other, more dangerous intracranial pathologies.
BACKGROUND: Intraocular injection of silicone oil is commonly performed during vitrectomy to tamponade the retina in place for treatment of retinal detachment. Although rare, this intravitreal silicone can migrate through the optic nerve and chiasm and enter the cerebral ventricles. CASE DESCRIPTION: Here we present a case report of a patient presenting with headache and intraventricular hyperdensities on a computed tomography (CT) scan, raising a concern for intraventricular hemorrhage. However, the intraventricular hyperdensities were in a nondependent location and moved to a new nondependent location when repeat imaging was performed with the patient in the prone position. We provide a literature review of this phenomenon and discuss the relevant CT and magnetic resonance imaging findings. CONCLUSIONS: Intraocular silicone can rarely migrate into the cerebral ventricular system. Careful review of the clinical history and imaging findings can help distinguish this from other, more dangerous intracranial pathologies.
Authors: Eric Curtis; David Constantinescu; Evan Fitchett; Edward Smitaman; Brian Curtis Journal: Intern Emerg Med Date: 2019-06-07 Impact factor: 3.397
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