THE CEREBRAL AND PERIPHERAL UPTAKE OF AMMONIA IN LIVER DISEASE WITH AN HYPOTHESIS FOR THE MECHANISM OF HEPATIC COMA 12

Abstract

Hepatic coma is a frequent terminal event in cirrhosis of the liver. Interest in its pathogenesis and treatment has been stimulated by recent observations that there is some relation between the increased blood ammonia level and the development of coma. In the course of a series of observations of the cerebral blood flow and oxygen uptake in a number of diseases, the cerebral arteriovenous difference of ammonia was also measured to test a hypothesis for the chemical mechanism of hepatic coma. This report deals with the cerebral and peripheral arteriovenous differences of ammonia in patients with cirrhosis of the liver, and in several other conditions.