Cerebral oedema and increased intracranial pressure in chronic liver disease
Cerebral oedema is a cause of morbidity and mortality in fulminant hepatic failure but has not been well documented as a complication of chronic liver diseases. We report here the development of cerebral oedema and increased intracranial pressure in 12 patients with chronic liver disease. Between Ju...
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| Veröffentlicht in: | The Lancet (British edition) 1998-03, Vol.351 (9104), p.719-721 |
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| creator | Donovan, Jeremiah P Schafer, Daniel F Shaw, Byers W Sorrell, Michael F |
| description | Cerebral oedema is a cause of morbidity and mortality in fulminant hepatic failure but has not been well documented as a complication of chronic liver diseases. We report here the development of cerebral oedema and increased intracranial pressure in 12 patients with chronic liver disease.
Between July 1, 1987, and Dec 31, 1993, we studied 12 patients aged 29–67 years with end-stage chronic liver disease. All the patients had cirrhosis, portal hypertension, hypoprothrombinaemia, hepatic encephalopathy, and decreased serum concentrations of albumin ( |
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Between July 1, 1987, and Dec 31, 1993, we studied 12 patients aged 29–67 years with end-stage chronic liver disease. All the patients had cirrhosis, portal hypertension, hypoprothrombinaemia, hepatic encephalopathy, and decreased serum concentrations of albumin (<25 g/L). During the study, the patients developed signs of increased intracranial pressure and had documented intracranial hypertension, cerebral oedema, or both. Intracranial hypertension was suspected on physical examination and confirmed by epidural catheters. We detected cerebral oedema by computed axial tomography of the head and necropsy of the brain when possible.
All the patients had intracranial hypertension and cerebral oedema. Two patients had successful treatment of cerebral hypertension with improvement of intracranial pressure such that orthotopic liver transplantation was undertaken. Both patients became neurologically normal after transplantation. Eight patients had only a transient reponse to treatment and died of cerebral oedema before a transplant could be done.
Cerebral oedema and increased intracranial pressure can occur in chronic liver disease and presents as neurological deterioration. Treatment guided by monitoring of intracranial pressure can lead to the reversal of intracranial hypertension, but in most patients cerebral oedema contributes to death or places them at too high a risk for liver transplantation.</description><identifier>ISSN: 0140-6736</identifier><identifier>EISSN: 1474-547X</identifier><identifier>DOI: 10.1016/S0140-6736(97)07373-X</identifier><identifier>PMID: 9504517</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Adult ; Aged ; Biological and medical sciences ; Brain ; Brain Edema - etiology ; Chronic Disease ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatic Encephalopathy - complications ; Humans ; Hypertension ; Intracranial Pressure ; Liver ; Liver Cirrhosis - complications ; Liver transplantation ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Medical disorders ; Medical research ; Medical sciences ; Middle Aged ; Other diseases. Semiology</subject><ispartof>The Lancet (British edition), 1998-03, Vol.351 (9104), p.719-721</ispartof><rights>1998 Elsevier Ltd</rights><rights>1998 INIST-CNRS</rights><rights>Copyright Lancet Ltd. Mar 7, 1998</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-9b7763f7c32ff04e6739b303055ae2f68efd6cb319442dbeb861e0b4c9023dea3</citedby><cites>FETCH-LOGICAL-c416t-9b7763f7c32ff04e6739b303055ae2f68efd6cb319442dbeb861e0b4c9023dea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S014067369707373X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2161837$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9504517$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donovan, Jeremiah P</creatorcontrib><creatorcontrib>Schafer, Daniel F</creatorcontrib><creatorcontrib>Shaw, Byers W</creatorcontrib><creatorcontrib>Sorrell, Michael F</creatorcontrib><title>Cerebral oedema and increased intracranial pressure in chronic liver disease</title><title>The Lancet (British edition)</title><addtitle>Lancet</addtitle><description>Cerebral oedema is a cause of morbidity and mortality in fulminant hepatic failure but has not been well documented as a complication of chronic liver diseases. We report here the development of cerebral oedema and increased intracranial pressure in 12 patients with chronic liver disease.
Between July 1, 1987, and Dec 31, 1993, we studied 12 patients aged 29–67 years with end-stage chronic liver disease. All the patients had cirrhosis, portal hypertension, hypoprothrombinaemia, hepatic encephalopathy, and decreased serum concentrations of albumin (<25 g/L). During the study, the patients developed signs of increased intracranial pressure and had documented intracranial hypertension, cerebral oedema, or both. Intracranial hypertension was suspected on physical examination and confirmed by epidural catheters. We detected cerebral oedema by computed axial tomography of the head and necropsy of the brain when possible.
All the patients had intracranial hypertension and cerebral oedema. Two patients had successful treatment of cerebral hypertension with improvement of intracranial pressure such that orthotopic liver transplantation was undertaken. Both patients became neurologically normal after transplantation. Eight patients had only a transient reponse to treatment and died of cerebral oedema before a transplant could be done.
Cerebral oedema and increased intracranial pressure can occur in chronic liver disease and presents as neurological deterioration. Treatment guided by monitoring of intracranial pressure can lead to the reversal of intracranial hypertension, but in most patients cerebral oedema contributes to death or places them at too high a risk for liver transplantation.</description><subject>Adult</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Brain</subject><subject>Brain Edema - etiology</subject><subject>Chronic Disease</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>Hepatic Encephalopathy - complications</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Intracranial Pressure</subject><subject>Liver</subject><subject>Liver Cirrhosis - complications</subject><subject>Liver transplantation</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Medical disorders</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Other diseases. 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Liver. Pancreas. Abdomen</topic><topic>Hepatic Encephalopathy - complications</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Intracranial Pressure</topic><topic>Liver</topic><topic>Liver Cirrhosis - complications</topic><topic>Liver transplantation</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Medical disorders</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Other diseases. 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Academic</collection><jtitle>The Lancet (British edition)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donovan, Jeremiah P</au><au>Schafer, Daniel F</au><au>Shaw, Byers W</au><au>Sorrell, Michael F</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cerebral oedema and increased intracranial pressure in chronic liver disease</atitle><jtitle>The Lancet (British edition)</jtitle><addtitle>Lancet</addtitle><date>1998-03-07</date><risdate>1998</risdate><volume>351</volume><issue>9104</issue><spage>719</spage><epage>721</epage><pages>719-721</pages><issn>0140-6736</issn><eissn>1474-547X</eissn><coden>LANCAO</coden><abstract>Cerebral oedema is a cause of morbidity and mortality in fulminant hepatic failure but has not been well documented as a complication of chronic liver diseases. We report here the development of cerebral oedema and increased intracranial pressure in 12 patients with chronic liver disease.
Between July 1, 1987, and Dec 31, 1993, we studied 12 patients aged 29–67 years with end-stage chronic liver disease. All the patients had cirrhosis, portal hypertension, hypoprothrombinaemia, hepatic encephalopathy, and decreased serum concentrations of albumin (<25 g/L). During the study, the patients developed signs of increased intracranial pressure and had documented intracranial hypertension, cerebral oedema, or both. Intracranial hypertension was suspected on physical examination and confirmed by epidural catheters. We detected cerebral oedema by computed axial tomography of the head and necropsy of the brain when possible.
All the patients had intracranial hypertension and cerebral oedema. Two patients had successful treatment of cerebral hypertension with improvement of intracranial pressure such that orthotopic liver transplantation was undertaken. Both patients became neurologically normal after transplantation. Eight patients had only a transient reponse to treatment and died of cerebral oedema before a transplant could be done.
Cerebral oedema and increased intracranial pressure can occur in chronic liver disease and presents as neurological deterioration. Treatment guided by monitoring of intracranial pressure can lead to the reversal of intracranial hypertension, but in most patients cerebral oedema contributes to death or places them at too high a risk for liver transplantation.</abstract><cop>London</cop><pub>Elsevier Ltd</pub><pmid>9504517</pmid><doi>10.1016/S0140-6736(97)07373-X</doi><tpages>3</tpages></addata></record> |
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| subjects | Adult Aged Biological and medical sciences Brain Brain Edema - etiology Chronic Disease Gastroenterology. Liver. Pancreas. Abdomen Hepatic Encephalopathy - complications Humans Hypertension Intracranial Pressure Liver Liver Cirrhosis - complications Liver transplantation Liver. Biliary tract. Portal circulation. Exocrine pancreas Medical disorders Medical research Medical sciences Middle Aged Other diseases. Semiology |
| title | Cerebral oedema and increased intracranial pressure in chronic liver disease |
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