That there is a relationship between the brain and the liver has been known for many years, and patientswith chronic liver diseasefrequently experience a wide spectrum of neurological problems thatcan adversely affect patient's neurocognitive functioning [1-3]. These neurological problems range from neurological complications such as hepatic myelopathy, acquired hepatocerebral degeneration, cognitive and mental status changes such as hepatic encephalopathy to metabolic, infective and hemorrhagic complications of liver cirrhosis; and, can severely restrict the patient’s functioning and also result in significant morbidity and mortality [3-6]. The...

LIVER-BRAIN AXIS Normal brain functioning depends on several aspects of normal liver functioning. For example, the liver supplies certain nutrients to the brain that the brain itself cannot produce. The liver also cleanses the blood of substances that could damage brain cells (i.e., neurotoxins, for e.g. ammonia, manganese, and other chemicals). In chronic liver disease and cirrhosis, the liver loses its capacity to remove toxic substances from the blood due to loss of functional liver cells (i.e., hepatocytes). Moreover, some of the blood that normally...

NEUROLOGY OF LIVER CIRRHOSIS NEUROIMAGING CHANGES IN CHRONIC LIVER DISEASE Cirrhotic patients frequently display changes on neuroimaging studies; although, these patients may or may not develop neurological symptoms [1-7]. The most striking neuroimaging manifestation includes high symmetrical and bilateral signal intensities of various extents involving the basal ganglia and the hypothalamus on T1WI [1, 7, 8]. Hyperintense signals in the basal ganglia, namely the globus pallidus, can be seen in as many as 70-100% of patients with liver cirrhosis (Fig 2) [1, 7]. Other sites...

Only with better understanding of the prevalence, clinical features and imaging manifestations of different neurological complications associated with liver cirrhosis and liver transplanatation, can we hope to aptly & promptly diagnose them and offer appropriate therapeutic options.

Ankur Arora, MD, DNB, FRCR, EDiR Assistant Professor Department of Radiology/ Interventional Radiology Institute of Liver & Biliary Sciences New Delhi, India Email: [email protected]

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