Brain and the Liver: Cerebral Edema, Hepatic Encephalopathy and Beyond

• Type of Material: Article
• Authors: Gagan Kumar, Northeast Georgia Health System; Amit Taneja, Medical College of Wisconsin; Prem Kandiah, Emory University
• Language: English
• Date: 2017-08-07
• Publisher: Springer
• Publication Version: Final Published Version
• Copyright Statement: © Springer International Publishing AG 2018
• Final Published Version (URL): http://dx.doi.org/10.1007/978-3-319-66432-3_8
• Title of Journal or Parent Work: Hepatic Critical Care
• Start Page: 83
• End Page: 103
• Keywords: intracranial hypertension; hepatic coma; acute-on-chronic liver failure; hepatic encephalopathy; chronic liver failure; acute liver failure; fulminant hepatic failure
• Research Categories: Health Sciences, Medicine and Surgery; Biology, Neuroscience

Abstract

Occurrence of brain dysfunction is common in both chronic liver disease as well as acute liver failure. While brain dysfunction most commonly manifests as hepatic encephalopathy is chronic liver disease; devastating complications of cerebral edema and brain herniation syndromes may occur with acute liver failure. Ammonia seems to play a central role in the pathogenesis of brain dysfunction in both chronic liver disease and acute liver failure. In this chapter we outline the pathophysiology and clinical management of brain dysfunction in the critically ill patients with liver disease.