title: Severe stroke: which medicine for which results?
abstract: In face of any severe stroke, the questions for health professionals in charge of the patient are: will the handicap be acceptable for the patient? But can we predict an acceptable handicap for the patient? For his family? When we know that the cognitive disorders, consequences of severe stroke often modify, in a major way, the behaviour of these patients? Given these difficulties for estimate vital and functional prognosis and even more the quality of life of patients with severe stroke, collective reflexions between physicians and nurses are essential, reflexions taking into account preferences and values of patients. Use of resuscitation resources for severe stroke patients implies to offer them the best rehabilitation. So, questions about health pathways for severe stroke are essential: which structures for these patients, which technologies, which medical, medico-social and social supports, which human accompaniment the society can propose to the patients and to their family, so that they have an acceptable quality of life.
authors.affiliation: Service de neurologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Agence régionale de santé Île-de-France, 35, rue de la Gare, 75019 Paris, France. Electronic address: france.woimant@lrb.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Woimant
authors.affiliation: Agence régionale de santé Île-de-France, 35, rue de la Gare, 75019 Paris, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Biteye
authors.affiliation: Service de neurologie, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Chaine
authors.affiliation: Service des urgences cérébrovasculaires, groupe hospitalier Pitié-Salpêtrière, AP-HP, 47-83, boulevard de l'Hôpital, 75013 Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Crozier
mesh_terms: D001925:Brain Damage, Chronic / Q000209:etiology / Q000517:prevention & control / Q000534:rehabilitation; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control; D003131:Combined Modality Therapy; D003244:Consciousness Disorders / Q000209:etiology / Q000517:prevention & control; D003422:Critical Care; D019468:Disease Management; D005602:France; D006699:Home Care Services; D006757:Hospital Units; D006801:Humans; D007326:Institutionalization; D007902:Length of Stay / Q000706:statistics & numerical data; D010166:Palliative Care; D010348:Patient Care Team; D010358:Patient Participation; D011379:Prognosis; D012121:Respiration, Artificial; D016414:Resuscitation Orders; D020521:Stroke / Q000453:epidemiology / Q000628:therapy*; D000071939:Stroke Rehabilitation
keywords: AVC; Care limitation; Limitation des thérapeutiques; Mechanical ventilation; Neurologic prognosis; Pronostic neurologique; Resuscitation; Réanimation; Stroke; Ventilation mécanique