When Seizures Lead to the Incidental Finding of Silicone Oil Migration

Silicone oil, commonly used as a temporary intraocular tamponade in retinal detachment repair, may have retrobulbar migration as a possible complication of the procedure to the cerebral ventricles. This report presents the case of a 73-year-old male patient with multiple cardiovascular risk factors and diffuse atherosclerotic disease who underwent vitrectomy of the left eye several years earlier due to retinopathy and was diagnosed through retrospective analysis of all cerebral imaging studies, with the migration of silicone oil particles, from the vitreous humor of the eye to the intraventricular space. He was admitted due to transient altered consciousness in the context of a probable seizure, with acute hyperdensity in the temporal horn of the left lateral ventricle observed in the cranial computed tomography (CT), suggestive of hemorrhage, along with signs of prior hemorrhage in the frontal horn of the same ventricle. The follow-up CT showed reabsorption of the hyperdensity seen in the admission CT, with a new hyperdense focus observed in the frontal horn of the same ventricle, a location matching that was seen in imaging studies performed eight years earlier. This focus exhibited a similar morphology, consistent with the mobilization of hyperdensity particles, according to the patient's head movements, which, considering the patient's medical history, led to the diagnosis of intraventricular migration of the silicone oil used in tamponade of the retinal detachment repair. The aim of this report is to describe a rare occurrence of intraocular silicone oil migration into the cerebral ventricles, which may be misinterpreted as intraventricular hemorrhage. This case highlights the importance of obtaining a detailed medical history with an integrative perspective and underscores the value of interdisciplinary collaboration in the diagnostic process.