Intracranial migration of intraocular silicone oil following repetitive head trauma

Abstract

Intraocular injection of silicone oil as a tamponade agent is a commonly used technique for the treatment of retinal detachment. An incompletely understood phenomenon which can occur after injection is the migration of silicone oil from the vitreous chamber to the intracranial space. Because the appearance of silicone oil can mimic hemorrhage or other pathologies on CT and MRI, careful comparison with prior studies is necessary to avoid unnecessary follow-up studies. We report a case of intracranial migration of intraocular silicone oil following repetitive head trauma.

Post-operative intracranial gas migration with optic nerve infiltration and atrophy following retinal detachment repair

“…Migration of exogenous intraocular material into the optic nerve and lateral ventricles is an exceedingly rare, but serious complication of retinal detachment repair. This complication has most frequently been reported after use of intraocular silicone oil, 5 , 6 , 7 , 8 , 9 , 10 possibly due to its permanent nature or differences in physical properties, such as lower surface tension, though there has been at least two other cases of intracranial gas migration. 2 , 3 In one instance, accidental injection of a high concentration of expansile gas led to intraocular pressures reaching 60 mmHg in an eye with known previous glaucomatous optic nerve atrophy.…”

Intraocular Silicone Oil Implant Migration in a Patient with a Craniopharyngioma

“…One rare complication associated with intraocular silicone oil is that it can migrate via the route of the optic nerve into the lateral ventricles of the brain. The mechanism of this complication is unclear but pathologies such as glaucoma, elevated intraocular pressure, proliferative diabetic retinopathy and trauma are possible explanations [12][13][14][15]. In a study of nineteen patients with no ocular abnormalities MRI failed to detect extraocular silicone oil in the orbit, optic nerve or cerebral ventricles at approximately four months after placement [20].…”

“…The exact mechanism for how intraocular silicone oil migrates from the eye to the cerebrospinal fluid (CSF) space is still not well understood. Some theories speculate that optic nerve conditions such as glaucoma, increased intraocular pressures and trauma can contribute to this condition [12][13][14][15].…”