[Dementia caused by miliary cerebral metastasis of a hepatocarcinoma]

Different types of tumors account for the etiology of 8.6% of all cases of dementia. Cerebral computed tomography (CT) permits the detection of most of them. The miliary metastasis variety commonly presents as dementia, and CT may then be normal. A patient with late epilepsy after cerebral infarction developed subacute dementia and he subsequently died. Post mortem study disclosed miliary cerebral metastases of a clinically unsuspected hepatocarcinoma. Cerebral CT did not detect the metastases. Although the incidence of hepatocarcinoma is increasing, we are unaware of any similar reported case, as cerebral involvement is exceptional in this condition. Despite its rarity, this case highlights the need to perform thorough neuropathological investigations in dementia.