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Accident vasculaire cérébral hémorragique

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Accident vasculaire cérébral et réanimation

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

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Résumé

Avec 750 000 nouveaux cas par an aux États-Unis, les accidents vasculaires cérébraux (AVC) demeurent la troisième cause de mortalité dans le monde, et certainement la première cause d’invalidité [1, 2]. Les AVC hémorragiques représentent 10 à 15 % de l’ensemble des AVC soit 10 à 20 cas par 100 000 habitants [3]. L’incidence augmente avec l’âge surtout au-delà de 55 ans, mais il existe également des facteurs génétiques. Chez les sujets de race noire ou les Japonais, l’incidence des AVC hémorragiques est deux fois plus élevée que dans le reste de la population [4]. Parmi les facteurs génétiques, O’Donnell et al. ont montré que la présence des allèles e2 et e4 sur les gènes codant pour l’apolipoprotéine E était associée à un risque trois fois plus important de récidive hémorragique [5]. L’AVC hémorragique est une pathologie grave, avec une mortalité à 30 jours comprise entre 35 et 52 % [6]. La moitié des décès surviennent dans les 48 premières heures suivant l’AVC. La survie à un an et à cinq ans est respectivement d’environ 42 et 27 % [7]. Seize ans après l’accident initial, seulement 19,3 % des patients de moins de 65 ans sont toujours en vie. L’admission dans des centres ayant l’habitude de prendre en charge ces patients améliore le pronostic. Comme pour l’AVC ischémique, la prise en charge des AVC hémorragiques dans une unité neurovasculaire diminue la mortalité, qui passe de 69 % à 52 % à un an.

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Authors and Affiliations

  1. Pôle anesthésie-réanimation, CHU Timone, Aix-Marseille Université, 264 rue St-Pierre, 13385, Marseille, France

    N. Bruder & L. Velly

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  1. N. Bruder
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  2. L. Velly
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Bruder, N., Velly, L. (2013). Accident vasculaire cérébral hémorragique. In: Accident vasculaire cérébral et réanimation. Le point sur…. Springer, Paris. https://doi.org/10.1007/978-2-287-99031-1_5

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  • DOI: https://doi.org/10.1007/978-2-287-99031-1_5

  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-287-99030-4

  • Online ISBN: 978-2-287-99031-1

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