Neurologic complications of foam sclerotherapy

The article is devoted to the description of a clinical case of neurological complications of foam sclerotherapy. The goal is to familiarize doctors with a fairly serious complication of the procedure, most often performed for cosmetic purposes. Stroke and transient ischemic attacks have been reported as “isolated cases” following sclerotherapy. Visual disturbances and complaints of headaches and migraines are much more common (0.1–1%). The main causes of these disorders are either gas embolism, which occurs immediately after the procedure, or paradoxical thromboembolism, which is recorded some time after sclerotherapy. The main cause of disorders is congenital heart disease, atrial or ventricular septal defect, however, total screening before the procedure is considered inappropriate. It is recommended to limit the volume of foam injected to 10 ml and carefully collect anamnesis. A history of heart disease with a right-to-left shunt is an absolute contraindication to the procedure. A clinical case is described with a 39-year-old patient who had previously unde rgone foam sclerotherapy sessions for cosmetic reasons. During the third session of sclerotherapy, the patient developed signs of acute cerebrovascular accident, which required hospitalization and treatment in the neurological department. Congenital heart disease has not been previously detected. Subsequently, with the treatment, all neurological disorders completely regressed. Conclusions. Doctors should be aware of the possibility of developing the serious complication described in the article, which, under unfavorable circumstances and lack of timely medical care, can lead to disability of the patient. If this complication develops, it is necessary to refer the patient to a neurologist as soon as possible to establish a diagnosis and begin therapy.