title: Neurologic manifestations of acute liver failure.
abstract: Fulminant hepatic failure presents with a hepatic encephalopathy and may progress to coma and often brain death from cerebral edema. This natural progression in severe cases contributes to early mortality, but outcome can be good if liver transplantation is appropriately timed and increased intracranial pressure (ICP) is managed. Neurologists and neurosurgeons have become more involved in these very challenging patients and are often asked to rapidly identify patients who are at risk of cerebral edema, to carefully select the patient population who will benefit from invasive ICP monitoring, to judge the correct time to start monitoring, to participate in treatment of cerebral edema, and to manage complications such as intracranial hemorrhage or seizures. This chapter summarizes the current multidisciplinary approach to fulminant hepatic failure and how to best bridge patients to emergency liver transplantation.
authors.affiliation: Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA.
authors.forename: Sudhir
authors.initials: S
authors.lastname: Datar
authors.affiliation: Division of Critical Care Neurology, Mayo Clinic, Rochester, MN, USA. Electronic address: wijde@mayo.edu.
authors.forename: Eelco F M
authors.initials: EF
authors.lastname: Wijdicks
mesh_terms: D006801:Humans; D017114:Liver Failure, Acute / Q000150:complications*; D009422:Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D059906:Neuroimaging
keywords: Hepatic encephalopathy; brain edema; complications; fulminant hepatic failure; hypothermia; intracranial pressure monitor; liver transplantation; neuroimaging; osmotic diuretics