Silicone tamponade migration into cerebral ventricles

Case contributed by Raul Emanuel Zambrana Valenzuela
Diagnosis probable

Presentation

Sudden onset generalized weakness.

Patient Data

Age: 40 years
Gender: Female

An axial CT in the prone position revealed a 1.1 x 1.6 cm nodular focus of hyperattenuating in the non-dependent aspect of the frontal horn of the left lateral ventricle as well as a separate 1.1 x 1.8 cm hyperattenuating focus in the non-dependent aspect of the temporal horn of the left lateral ventricle.

1.1 x 1.6 cm focus of abnormal signal in the frontal horn of the left lateral ventricle and the separate 1.1 x 1.8 cm lesion in the non-dependent aspect of the temporal horn of the left lateral ventricle. Pre-contrast T1-weighted images demonstrate T1 shortening effects/hyperintense signal within these lesions, relative to the cerebrospinal fluid. On T2 it is relatively isointense compared to cerebrospinal fluid and has a chemical shift artifact.

Case Discussion

The literature has reported patients with end-stage renal disease have an increased risk of complete retinal detachment following multiple rounds of dialysis. Although rare, retinal detachment with silicone tamponade is essential to remember as patients with neurological findings and silicone within the ventricles can be mistaken for a hemorrhage

Case supervised by Dr Carlos Weber Seda, MD, neuroradiologist.

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