Changes in the cerebellar cortex in rats after portocaval anastomosis

Abstract

After portocaval anastomosis, rats develop focal vacuolation, with apparent homogenization and loss of Purkinje cells and accompanying gliosis, in the depths of the cerebellar folia. The vacuolation represents focal swelling of astrocyte processes. This appears from the 5th week and continues to occur up to 38 weeks after operation. The severity of the cerebellar changes appear to be directly related to the plasma NH 4-N level. It is argued that these changes are closely similar to those found in human patients with acquired hepatic encephalopathy, and that they are part of a general metabolic stress induced by the persistently high plasma ammonia level on the astrocyte cellular compartment.