Diffuse Cerebral Edema and Impending Herniation Complicating Hepatic Encephalopathy in Hereditary Hemorrhagic Telangiectasia

Figure 3

Sagittal and axial head CT performed before and 12 hours after the patient developed severe hyperammonemia. (a, b) Normal sagittal and axial brain CT. (c, d). Repeat head CT after clinical deterioration revealed diffuse hypodense cytotoxic edema with compression of the lateral ventricles and sulcal effacement. Sagittal view demonstrates interval compression of the subarachnoid cisterns and cerebellar tonsil herniation.

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