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Master Thesis

Évaluation pronostique des patients présentant une mydriase suite à un évènement neurologique aigu pris en charge de manière active en milieu neurochirurgical

Abstract : The vital and functional prognosis of patients with mydriasis following an acute neurological event, rather dark, is however very heterogeneous. Therefore we have conducted a review of these patients in our center to evaluate at 6 months their mortality and functional outcome with the Glasgow Outcome Scale (GOS) and the modified Rankin score and search for prognostic factors. The 6-month survival rate was 68%. Functionally, 68% of surviving patients had a good outcome with a GOS at 4 or 5, but only 14% could resume all their previous activities (modified Rankin score at 0 or 1), only 9% of patients were in a chronic vegetative state (GOS 2). The study of the vital and functional prognostic factors revealed several significant factors of good prognosis, some already known in the literature: a high initial Glasgow Coma Scale, the unilateral and reversible nature of mydriasis, a surgical management of patients with craniotomy; and revealed other new factors: the absence of initial hemodynamic instability, the absence of anomalies at the trans-cranial Doppler, the absence of diffuse hemorrhagic lesions on the initial CT scan, a low troponin level, a low duration of mechanical ventilation, of the stay in intensive care unit and in hospital. Thus, although our study was focused on patients receiving active management, both vital and functional prognosis does not seem so dark and this result tends to validate an interventionist therapeutic attitude, at least for the initial care.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03210952
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Wednesday, April 28, 2021 - 12:00:48 PM
Last modification on : Saturday, September 4, 2021 - 3:26:07 AM

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François-Léopold Maison. Évaluation pronostique des patients présentant une mydriase suite à un évènement neurologique aigu pris en charge de manière active en milieu neurochirurgical. Médecine humaine et pathologie. 2019. ⟨dumas-03210952⟩

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