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Causes of death for the 101 patients who died within the 3-week period included cerebral edema, multiorgan failure, sepsis, cardiac arrhythmia or arrest and respiratory failure. The median time to death after admission was 5 days.
Clinical signs of cerebral edema, such as focal neurological deficits, papilledema [5] and decreased level of consciousness, if temporally associated with recent hemodialysis, suggest the diagnosis. A computed tomography of the head is typically done to rule-out other intracranial causes. [citation needed]
In a small proportion of cases, the encephalopathy is caused directly by liver failure; this is more likely in acute liver failure. More commonly, especially in chronic liver disease, hepatic encephalopathy is triggered by an additional cause, and identifying these triggers can be important to treat the episode effectively. [4]
Cerebral edema is commonly seen in a variety of brain injuries including ischemic stroke, subarachnoid hemorrhage, traumatic brain injury, subdural, epidural, or intracerebral hematoma, hydrocephalus, brain cancer, brain infections, low blood sodium levels, high altitude, and acute liver failure.
Classification for hepatic insufficiency. In hyperacute and acute liver failure, the clinical picture develops rapidly with progressive encephalopathy and multiorgan dysfunction such as hyperdynamic circulation, coagulopathy, acute kidney injury and respiratory insufficiency, severe metabolic alterations, and cerebral edema that can lead to brain death.
End organ damage is severe impairment of major body organs due to systemic disease. Commonly this is referred to in diabetes, high blood pressure, or states of low blood pressure or low blood volume. [1] This can present as a heart attack or heart failure, pulmonary edema, neurologic deficits including a stroke, or acute kidney failure. [2]
Reye syndrome is a rapidly worsening brain disease. [2] Symptoms of Reye syndrome may include vomiting, personality changes, confusion, seizures, and loss of consciousness. [1] While liver toxicity typically occurs in the syndrome, jaundice usually does not. [2]
Patients with RVCL develop vision loss, brain lesions, strokes, brain atrophy, and dementia. Other organ are also involved in many cases, including the kidney, liver, gastrointestinal tract, thyroid, and bone. Symptoms of RVCL commonly begin between ages 35 and 55, although sometimes disease onset occurs earlier or later.