The Patient with Severe Co-morbidities: CNS Disease and Increased Intracranial Pressure

  • Prashanth Nandhabalan
  • Chris Willars
  • Georg Auzinger


Intracranial hypertension presents specific challenges for the anesthesiologist during liver transplantation. The goal of reducing and avoiding surges of intracranial pressure is often in conflict with general anesthetic goals. It is crucial to maintain cerebral perfusion and protect the brain during surgery. Neurological complications are frequent and can be detrimental. This chapter will review the pathophysiology of intracranial hypertension in acute liver failure as well as perioperative strategies to prevent and treat it in order to avoid catastrophic neurological outcomes.

Intracranial Hypertension in Acute Liver Failure

Etiology and Pathophysiology of Encephalopathy and Cerebral Edema in Acute Liver Failure

Intracranial hypertension (ICH) is a common cause of death in acute liver failure (ALF) [1]. The concept of cerebral edema and hyperemia as a cause of the acute rise in intracranial pressure (ICP) in ALF was first described in the early 1970s [2]. While the...


Intracranial hypertension Ammonia Cerebral blood flow Intracranial pressure Transcranial Doppler Therapeutic hypothermia Cerebral edema Hepatic encephalopathy 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Prashanth Nandhabalan
    • 1
  • Chris Willars
    • 1
  • Georg Auzinger
    • 1
  1. 1.Department of Critical Care/Institute of Liver StudiesKing’s College HospitalLondonUK

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