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CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(07): 470-476
DOI: 10.1590/0004-282X20170076
VIEWS AND REVIEWS

Cerebral hemodynamic and metabolic changes in fulminant hepatic failure

Modificações da hemodinâmica e metabolismo cerebral na insuficiência hepatica fulminante
Fernando Mendes Paschoal Junior
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
2   Universidade Federal do Pará, Faculdade de Medicina, Universidade Federal do Pará, Belém PA, Brasil;
,
Ricardo de Carvalho Nogueira
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
,
Marcelo de Lima Oliveira
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
,
Eric Homero Albuquerque Paschoal
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
2   Universidade Federal do Pará, Faculdade de Medicina, Universidade Federal do Pará, Belém PA, Brasil;
,
Manoel Jacobsen Teixeira
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
,
Luiz Augusto Carneiro D’Albuquerque
3   Universidade de São Paulo, Faculdade de Medicina, Departamento de Gastroenterologia, São Paulo SP, Brasil.
,
Edson Bor-Seng-Shu
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, Divisão de Cirurgia Neurológica, Laboratório de Neurosonologia e Hemodinâmica Cerebral, São Paulo SP, Brasil;
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ABSTRACT

Intracranial hypertension and brain swelling are a major cause of morbidity and mortality of patients suffering from fulminant hepatic failure (FHF). The pathogenesis of these complications has been investigated in man, in experimental models and in isolated cell systems. Currently, the mechanism underlying cerebral edema and intracranial hypertension in the presence of FHF is multi-factorial in etiology and only partially understood. The aim of this paper is to review the pathophysiology of cerebral hemodynamic and metabolism changes in FHF in order to improve understanding of intracranial dynamics complication in FHF.

RESUMO

O edema cerebral e a hipertensão intracraniana (HIC) são as principais causas de morbidade e mortalidade de pacientes com insuficiência hepática fulminante (IHF). A patogênese dessas complicações tem sido investigada no homem, em modelos experimentais e em sistemas celulares isolados. Atualmente, o mecanismo subjacente ao edema cerebral e HIC na presença de IHF é multifatorial em etiologia e pouco compreendido na literatura. O objetivo deste trabalho é revisar a fisiopatologia das alterações hemodinâmicas e metabólicas cerebrais na IHF, visando melhorar a compreensão da complicação da hemodinâmica encefálica na IHF.

hepatic insufficiency - intracranial hypertension - brain edema
insuficiência hepatica - hipertenção intracraniana - edema encefálico


Publication History

Received: 24 January 2017

Accepted: 30 March 2017

Article published online:
05 September 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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