{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T15:12:40Z","timestamp":1781795560301,"version":"3.54.5"},"reference-count":37,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[1995,3,1]],"date-time":"1995-03-01T00:00:00Z","timestamp":794016000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cereb Blood Flow Metab"],"published-print":{"date-parts":[[1995,3]]},"abstract":"<jats:p>\n                    Alterations in cerebral hemodynamics are postulated to contribute to brain herniation, a major cause of death in patients with severe hepatic encephalopathy due to fulminant hepatic failure (FHF). In an effort to identify these changes in cerebral hemodynamics, regional and global cerebral blood flow (CBF) and CO\n                    <jats:sub>2<\/jats:sub>\n                    reactivity were measured using stable xenon-enhanced computed tomography (Xe\/CT) in 24 patients within 72 h of onset of severe hepatic encephalopathy. Regional variations in CBF, most notably, a relative decrease in CBF in the anterior circulation and an increase in CBF in the posterior circulation were found. CBF was significantly lower in FHF patients compared with controls, however, these values are well out of the established ischemic range. FHF patients also showed significant impairment in CBF response to hypoventilation, while the CBF response to hyperventilation remained intact. This study suggests that FHF patients demonstrate early changes in both CBF patterns and CO\n                    <jats:sub>2<\/jats:sub>\n                    reactivity. The relatively \u201cnormal\u201d CBF values obtained in FHF patients in severe hepatic encephalopathy coupled with the lack of vasodilatation to hypoventilation suggest a state of uncoupled CBF and metabolism or \u201cluxury perfusion\u201d that could theoretically contribute to vasogenic edema, brain swelling, and cerebral herniation.\n                  <\/jats:p>","DOI":"10.1038\/jcbfm.1995.38","type":"journal-article","created":{"date-parts":[[2011,4,8]],"date-time":"2011-04-08T13:19:33Z","timestamp":1302268773000},"page":"329-335","source":"Crossref","is-referenced-by-count":44,"title":["Regional Cerebral Blood Flow and CO\n                    <sub>2<\/sub>\n                    Reactivity in Fulminant Hepatic Failure"],"prefix":"10.1177","volume":"15","author":[{"given":"Susan","family":"Durham","sequence":"first","affiliation":[{"name":"Departments of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard","family":"Yonas","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."},{"name":"Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shushma","family":"Aggarwal","sequence":"additional","affiliation":[{"name":"Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Darby","sequence":"additional","affiliation":[{"name":"Departments of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."},{"name":"Anesthesiology and Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Kramer","sequence":"additional","affiliation":[{"name":"Radiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[1995,3,1]]},"reference":[{"key":"bibr1-jcbfm.1995.38","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.4.5.725"},{"key":"bibr2-jcbfm.1995.38","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840190114"},{"key":"bibr3-jcbfm.1995.38","doi-asserted-by":"publisher","DOI":"10.3109\/00365528909093050"},{"key":"bibr4-jcbfm.1995.38","first-page":"346","volume":"56","author":"Alternau LL","year":"1977","journal-title":"Acta Neurol Scand"},{"key":"bibr5-jcbfm.1995.38","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1111\/j.1600-0404.1977.tb05856.x","volume":"56","author":"Baldy-Moulinier M","year":"1977","journal-title":"Acta Neurol 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