Brain edema and intracranial hypertension in fulminant hepatic failure: Pathophysiology and management

Figure 1 Computed tomography (CT) (sagittal sections) of the brain of a 17-year old man who developed fulminant hepatic failure. A: First CT performed in encephalopathy stage IV; B: Control CT performed when the patient developed unilateral fixed midriasis, showing diffuse edema, compression of the fourth ventricle and of the brain stem. The patient developed brain stem death while waiting liver transplantation, despite medical therapy and MARS treatment.

Figure 2 Schematic representation of the hypotheses explaining intracranial hypertension and brain stem death in fulminant hepatic failure.