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Intraocular injected silicone may migrate from the vitreous into the subarachnoid space of the optic sheath surrounding the intraorbital segment of the optic nerve to eventually settle in the intracranial subarachnoid spaces and the intraventricular system, mimicking intracranial hemorrhage. The unique characteristics of silicone including high density (HU > 90), non-dependent location within the ventricles, identical appearance on follow-up imaging, as well as presence of chemical shift artifact evident on MR imaging, can be utilized in differentiating silicone from blood in the acute setting.






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From the manuscript

Intracranial Migration of Silicone Delaying Life Saving Surgical Management: A Mimicker of Hemorrhage

Free full text article: Intracranial Migration of Silicone  Delaying Life Saving Surgical Management:  A Mimicker of Hemorrhage

Abstract
We present a case in which intraocular silicone injection for complex retinal detachment resulted in migration and distribution of silicone along the intracranial visual pathway, and ultimately throughout the ventricular system. Misinterpretation of this material as intracranial hemorrhage on outside computed tomography imaging delayed emergent repair of a Type A aortic dissection until the diagnosis was made on repeat imaging. A discussion of this case and salient computed tomography and magnetic resonance imaging characteristics of silicone is provided.






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1. Intraocular silicone

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