Annales françaises d'anesthèsie et de rèanimation
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Ann Fr Anesth Reanim · Sep 2010
[Does intracranial pressure monitoring improve outcome after severe traumatic brain injury?].
Raised intracranial pressure (ICP) is frequent and associated with poor outcome after severe traumatic brain injury (TBI). Information obtained by ICP monitoring allows early detection of high ICP and goal-directed therapy. ⋯ ICP monitoring and guided therapy are not risk-free. A rational use of ICP as a guide to therapy must take into account of the absolute threshold for treatment, but also of the risk/benefit balance of the used intervention.
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Ann Fr Anesth Reanim · Sep 2010
[Ultrasound-guided supraclavicular subclavian vein catheterization: a novel approach in children].
The subclavian vein (SCV) is often the preferred site for long-term central venous catheterization in children. It has many advantages over the internal jugular vein. But with the classical landmark technique for SCV catheterization the ultrasound-guidance technique is usually not suitable, because of the clavicle (a bright hyperechoic structure with an acoustic shadow beneath it). Because the SCV can easily be visualized via a supraclavicular approach, we developed a useful ultrasound-guided approach for SCV catheterization in infants and children.
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Bilateral thalamic infarction is a very rare affection. We report here a case of bithalamic infarction during subclavian catheterization related to the accidental migration and complete occlusion of an arterial embolism to the Percheron's artery. Percheron's artery is an anatomical variation described in 1977, constituted by a solitary arterial trunk arising from one of the proximal segments of a posterior cerebral artery supplying the paramedian thalami and the rostral midbrain bilaterally. We review here the clinical presentation and discuss the aetiologies of such a cerebral infarction.