[Hepatic encephalopathies; hemodynamic and metabolic study of the influence of ammonia and levodopa]

The authors present the results of a study of cerebral blood flow and energy metabolism carried out in 19 subjects, 12 of whom had hepatic cirrhosis and hepatic encephalopathy (HE). The spontaneous changes and those noted after intravenous administration of ammonium chloride and of L. Dopa, shows that the signs of hepatic encephalopathy are not directly related to the reduction in energy metabolism and that this metabolic disorder does not depend on a blocking of the dopaminergic synopses. The results of this study emphasize the complexity of HE and raise up the hypothesis of the creation of intra-cerebral arterio-venous shunts in cirrhotic patients.