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Traitement des hématomes intracrâniens

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Accident vasculaire cérébral et réanimation

Part of the book series: Le point sur… ((POINT))

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Résumé

L’hématome intracrânien (HIC) est une extravasation de sang dans le parenchyme cérébral. C’est une pathologie grave, très destructrice pour le parenchyme, dont la mortalité est très lourde, autour de 40 %, avec seulement 25 % de survivants indépendants à six mois [1]. Plus de 85 % de ces hémorragies sont spontanées, dues à la rupture d’une artère ou d’une artériole pénétrante endommagée par une hypertension artérielle chronique ou une angiopathie amyloïde. L’HIC n’atteint pas sa taille finale immédiatement et le volume peut s’accroître pendant 24 heures [2], justifiant l’attention portée ces dernières années au traitement agressif des premières heures pour stopper la progression du saignement. Le développement de l’hématome est, avec la localisation et l’extension intraventriculaires de l’hémorragie, parmi les principaux facteurs pronostiques. à l’arrivée du patient à l’hôpital, les praticiens rencontrent trois problèmes cliniques: contrôler le niveau de la pression artérielle, reverser un éventuel traitement anticoagulant et déterminer les indications chirurgicales.

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Authors and Affiliations

  1. APHP, Département d’anesthésie réanimation, CHU de Bicêtre, 94275, Le Kremlin Bicêtre, France

    B. Vigué & P.-E. Leblanc

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  1. B. Vigué
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  2. P.-E. Leblanc
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Vigué, B., Leblanc, PE. (2013). Traitement des hématomes intracrâniens. In: Accident vasculaire cérébral et réanimation. Le point sur…. Springer, Paris. https://doi.org/10.1007/978-2-287-99031-1_9

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  • DOI: https://doi.org/10.1007/978-2-287-99031-1_9

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-99030-4

  • Online ISBN: 978-2-287-99031-1

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