Key messages

• The cerebral edema that accompanies or is part of fulminant hepatic encephalopathy is a common cause of death.

• Management of cerebral edema involves optimization of liver function, and monitoring of and measures to reduce the intracranial pressure.

• The most effective treatment of elevated intracranial pressure is mannitol infusion.

• Infection is common and is often fungal after the first week of management in the intensive care unit.

• Hypoglycemia must be excluded as a cause of deteriorating mental state.

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