Headaches secondary to intraventricular silicone oil successfully managed with ventriculoperitoneal shunt.
OBJECTIVE
To describe a case of intravitreal silicone oil (SO) migration into the cerebral ventricles with secondary chronic headaches.


METHODS
Retrospective case report. Chart review. Single patient.


RESULTS
A 51-year-old man with a history of proliferative diabetic retinopathy underwent surgery for traction retinal detachment using SO. Postoperatively, he developed elevated intraocular pressure, headaches, and a blind painful eye, which was enucleated. Neuroimaging revealed SO within the cerebral ventricles. Five years after the initial retinal detachment surgery, the patient developed chronic headaches. Lumbar puncture revealed an elevated opening pressure. The headaches were initially managed medically. A ventriculoperitoneal shunt was placed after the headaches persisted, which resulted in their complete resolution at 6 weeks after shunt placement.


CONCLUSIONS
Ocular hypertension after intravitreal SO placement may play a role in SO intracranial migration. In the case presented, intraventricular SO was the apparent cause of elevated intracranial pressure and headaches. As all published cases of intraventricular SO migration reporting intraocular pressure to this point have described ocular hypertension, careful monitoring of intraocular pressure and aggressive control of ocular hypertension in the presence of intravitreal SO is recommended.
*Departments of Ophthalmology and Visual Sciences, and †Neurosurgery, University of Nebraska Medical Center, Omaha, Nebraska; and ‡VA Nebraska-Western Iowa Health Care System, Omaha, Nebraska.
Paul M
PM
Hruby
Preeti R
PR
Poley
Patricia A
PA
Terp
William E
WE
Thorell
Eyal
E
Margalit