MIDDLE CEREBRAL-ARTERY BLOOD-FLOW VELOCITY PATIENTS WITH CIRRHOSIS

Background: Brain dysfunction is common in patients with advanced live r disease; it is often manifested as hepatic encephalopathy, but its c ause is not clearly understood. Methodology: Intracranial blood flow v elocity parameters, including peak systolic velocity, end diastolic ve locity and mean velocity of both middle cerebral arteries were measure d by transcranial Doppler ultrasonography in 37 patients with cirrhosi s without encephalopathy (16 Child's A,10 Child's B and 11 Child's C) and 12 normal controls. The cause was alcohol-related in 24 and non-al cohol-related in 13. Results: No significant differences in any of the Doppler parameters were detected in Child's group A when compared wit h controls. However, a statistically significant decrease in middle ce rebral artery blood flow velocity was evident when Child's B and C pat ients without clinically apparent encephalopathy were compared with co ntrols irrespective of the cause. Our results demonstrate that intracr anial blood flow is abnormal in patients with advanced liver disease w ithout clinically apparent encephalopathy.