Intraventricular silicone oil migration post-retinal detachment surgery: diagnostic features and classification – a case study with literature review

This case report documents a rare instance of intraventricular migration of silicone oil (IVM-SiO), initially misinterpreted as intraventricular hemorrhage on computed tomography (CT), in a patient with a history of retinal detachment surgery. The report not only describes the unique presentation of this case but also synthesizes findings from previous case reports to summarize the diagnostic characteristics and classification of intracranial silicone oil migration. The patient, a 41-year-old male, presented with dizziness and a history of vitreoretinal surgeries, including silicone oil tamponade for retinal detachment. Initial CT scans revealed a high-density lesion in the left ventricular body, suggestive of hemorrhage. However, further diagnostic workup, including MRI and a detailed review of the patient's surgical and radiological history, led to the identification of IVM-SiO. This report discusses the radiological features and differential diagnosis of IVM-SiO, underlining the diagnostic challenges in distinguishing it from other intraventricular pathologies. The case highlights the importance of considering a history of vitreoretinal surgery in patients presenting with intraventricular lesions. It also presents a classification system for intracranial silicone oil based on its migration patterns and imaging characteristics, contributing to the growing body of literature on this rare but significant complication.