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Prise en charge d’un patient atteint d’un traumatisme médullaire

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La réanimation neurochirurgicale

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

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Abstrait

Le traumatisme médullaire est une pathologie qui atteint plus de 1 000 personnes adultes par an en France. Ce sont en général des sujets jeunes en pleine santé antérieurement pour lesquels le traumatisme médullaire provoque un drame humain, économique, social, familial et psychologique terrible. La prise en charge d’un patient atteint d’un traumatisme médullaire a fait l’objet d’une conférence d’experts française récente (1). Ces recommandations, établies en 2003, avaient fait la synthèse sur un ensemble de sept questions primordiales concernant la prise en charge initiale et secondaire, en vue d’une harmonisation des pratiques nationales pour améliorer l’avenir fonctionnel de ces patients. Il faut souligner le faible niveau de preuve des études de la littérature ne permettant, dans la conférence d’experts, de n’établir que des recommandations de grade D ou E. Ce court chapitre ne peut reprendre tout l’argumentaire de la conférence et vise donc essentiellement à décrire les principes de la pratique de la prise en charge clinique, en sachant qu’il persiste de nombreuses zones d’ombre. Il ne fait pas de doute que la prise en charge s’est très nettement améliorée durant les 30 dernières années. Une étude montrait une diminution du risque de décès pendant la première année suivant le traumatisme de 67%, à gravité des patients comparable, entre les années 1970 et les années 1990 (2).

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Author information

Authors and Affiliations

  1. Département d’Anesthésie-Réanimation, Hôpital Neurologique, 59, Boulevard Pinel, 69393, Lyon Montchot Cedex

    Thomas Lieutaud

  2. Département d’Anesthésie-Réanimation, CHU Timone, 264, rue Saint-Pierre, 13385, Marseille

    Nicolas Bruder

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  1. Thomas Lieutaud
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  2. Nicolas Bruder
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Editor information

Editors and Affiliations

  1. Département d’Anesthésie-Réanimation, CHU Timone, 264, rue Saint-Pierre, 13385, Marseille

    Nicolas Bruder

  2. Département d’Anesthésiologie et Réanimation, Hôpital Régional, Avenue du grand Champsec 80, CH-1951, Sion (Suisse)

    Patrick Ravussin

  3. Department of Anaesthesia, The Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8

    Bruno Bissonnette

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Lieutaud, T., Bruder, N. (2007). Prise en charge d’un patient atteint d’un traumatisme médullaire. In: Bruder, N., Ravussin, P., Bissonnette, B. (eds) La réanimation neurochirurgicale. Le point sur …. Springer, Paris. https://doi.org/10.1007/978-2-287-68199-8_18

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  • DOI: https://doi.org/10.1007/978-2-287-68199-8_18

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-68198-1

  • Online ISBN: 978-2-287-68199-8

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