Increased Intracranial Pressure and Hepatic Encephalopathy in Chronic Liver Disease

J. S. Crippin, J. B. Gross, K. D. Lindor

Research output: Contribution to journalArticlepeer-review

34 Scopus citations


Increased intracranial pressure is present in more than 80% of patients with fulminant hepatic failure. However, patients with encephalopathy secondary to chronic liver disease are thought not to develop elevated intracranial pressure. We report two patients with chronic liver disease in hepatic coma with raised intracranial pressure documented by an epidural intracranial pressure monitor. One patient rapidly deteriorated to coma over a period of 4 h. The other patient progressively worsened following intravenous sedation administered during upper endoscopy. Both patients had generalized tonic‐clonic seizures, and one demonstrated decerebrate posturing and papilledema. Although all metabolic and structural abnormalities should be excluded in patients with hepatic encephalopathy, if the etiology remains in question, the possibility of increased intracranial pressure should be considered in patients with chronic liver disease.

Original languageEnglish (US)
Pages (from-to)879-882
Number of pages4
JournalThe American Journal of Gastroenterology
Issue number7
StatePublished - Jul 1992
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology


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