Oxidative and nitrosative stress in ammonia neurotoxicity

► Ammonia accumulation in brain is a primary cause of hepatic encephalopathy (HE). ► Cytotoxic brain edema, a fatal complication of HE is due to astrocytic swelling (AS). ► AS in HE is a consequence of ammonia-induced oxidative nitrosative stress (AIONS). ► AIONS in the vascular endothelial cells contributes to vasogenic brain edema. ► In an antioxidative response to AIONS, astrocytes increase glutathione synthesis.