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, Annexe 3 : Facteurs devant faire réaliser le scanner cérébral immédiatement

E. Jehlé and C. Grasleguen, Traumatisme crânien léger (score de Glasgow de 13 à 15) : triage, évaluation, examens complémentaires et prise en charge précoce chez le nouveau-né, l'enfant et l'adulte: Société française de médecine d'urgence, Ann Fr Médecine Urgence. mai, vol.2, issue.3, pp.199-214, 2012.

, Annexe 4 : Critères d'hospitalisation à la suite d'un traumatisme crânien léger

E. Jehlé and C. Grasleguen, Traumatisme crânien léger (score de Glasgow de 13 à 15) : triage, évaluation, examens complémentaires et prise en charge précoce chez le nouveau-né, l'enfant et l'adulte: Société française de médecine d'urgence, Ann Fr Médecine Urgence. mai, vol.2, issue.3, pp.199-214, 2012.

, L'événement traumatique est constamment revécu de l'une (au moins) des façons suivantes: 1. Souvenirs répétitifs et envahissants de l'événement provoquant un sentiment de détresse et comprenant des images des pensées ou des perceptions

, Rêves répétitifs de l'événement provoquant un sentiment de détresse

, Impression ou agissements soudains « comme si » l'événement traumatique allait se reproduire (illusions, hallucinations, flash-back)

, Sentiment intense de détresse psychologique lors de l'exposition à des indices externes ou internes évoquant ou ressemblant à un aspect de l'évènement traumatique en cause

, Réactivité physiologique lors de l'exposition à des indices internes ou externes pouvant évoquer un aspect de l'événement traumatique en cause

C. , Symptômes d'évitement et d'émoussement Evitement persistant des stimuli associés au traumatisme et émoussement de la réactivité générale (ne préexistant pas au traumatisme), avec au moins trois des manifestations suivantes: 1. Efforts pour éviter les pensées

, Efforts pour éviter les activités, les endroits où les gens qui éveillent des souvenirs du traumatisme

, Incapacité à se rappeler un aspect important du traumatisme

, Réduction nette de l'intérêt pour des activités antérieurement importantes ou réduction de la participation à ces mêmes activités

, Sentiment de détachement d'autrui ou bien sentiment de devenir étranger aux autres personnes

, Restriction des affects (par exemple : incapacité à éprouver des sentiments tendres)

, Sentiment de restriction sur l'avenir (par exemple : ne pas pouvoir faire carrière, se marier, avoir des enfants

D. , Symptômes neurovégétatifs Présence de symptômes persistants traduisant une activation neurovégétative (ne préexistant pas au traumatisme) avec au moins deux des manifestations suivantes: 1. Difficultés d'endormissement ou sommeil interrompu

, Difficultés de concentration

. Hyper-vigilance,

, Réactions de sursaut exagérées E. Les perturbations des critères B, C et D durent plus d'un mois

F. , La perturbation entraîne une souffrance cliniquement significative ou une altération du fonctionnement social

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L. Serment-d'hippocrate,

, Dans les suites, une proportion non négligeable de patients va présenter des symptômes persistants d'ordre somatique, cognitif et/ou psychologique connus sous le nom de « syndrome post-commotionnel » (SPC). Les travaux traitant de ses conséquences sur la vie professionnelle et la qualité de vie des patients demeurent rares. L'objectif principal de cette étude, Les répercussions socioprofessionnelles du syndrome post-commotionnel chez les traumatisés crâniens légers Résumé Introduction : 160

. Méthode, Etude qualitative portant sur 11 entretiens individuels semi-directifs de patients victimes de SPC après un TCL dans le sud de La Réunion

, Ces conséquences engendraient un handicap quotidien chez nos patients. La perte de confiance en soi était unanimement évoquée. Celle-ci semblait être à l'origine d'un cercle vicieux constitué de perceptions négatives et néfastes qui contribuaient à une chronicisation du SPC et de ses répercussions, Résultats : La présence de répercussions socioprofessionnelles et d'une dégradation de la qualité de vie chez les patients victimes de SPC était indiscutable

, Une éducation précoce sur les symptômes du SPC, la garantie d'un pronostic favorable et de la reprise des activités antérieures semblent constituer les éléments fondamentaux d'une prise en charge efficace, Conclusion : Le médecin généraliste a un rôle central dans la prévention et le dépistage du SPC