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042 Hydrophilic polymer embolisation causing subacute dementia
  1. Naheed Raza,
  2. Peter Fernandez,
  3. Fiona Moreton,
  4. Siddharthan Chandran
  1. Department of Neurology, Western General Hospital, Crewe Road South, Edinburgh EH4 2XU


A 64-year-old woman presented with a 6-week history of progressive cognitive impairment and social withdrawal. Examination showed right homonymous hemianopia, left-right disorientation, astereognosis and dyspraxia. 3 months previously she had suffered a Grade I subarachnoid haemorrhage secondary to a ruptured anterior communicating artery aneurysm. This was treated with endovascular coiling. She initially recovered well but developed difficulties with activities of daily living and impaired memory over the following weeks. MRI brain revealed a multitude of enhancing foci associated with surrounding white matter hyperintensities and oedema throughout the left hemisphere. The imaging was consistent with hydrophilic polymer embolisation. She was treated with IV methylprednisolone followed by a tapering regime of oral steroids and azathioprine. There was a gradual but incomplete improvement in imaging and clinical findings over 6 months. We believe this is the first case of subacute dementia resulting from polymer coated emboli. Hydrophilic polymer embolisation remains an elusive and potentially under diagnosed phenomenon associated with a range of adverse clinical sequelae which may occur throughout the body. It may be on the rise due to an increasing trend towards minimally invasive and novel drug delivery systems.

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