Rebound surges of intracranial pressure as a consequence of forced ultrafiltration used to control intracranial pressure in patients with severe hepatorenal failure.

Cerebral edema remains the most common immediate cause of death in patients with fulminant hepatic failure. We have used ultrafiltration as a method of controlling intracranial pressure (ICP) when other measures have failed. Two cases in which an initial decrease in ICP was followed by a marked rebound increase resulting in death are reported.