IngentaConnect Magnesium therapy within 48 hours of an aneurysmal subarachnoid h...

Authors: Wong, George K.C.¹; Chan, Matthew T.V.²; Poon, Wai S.¹; Boet, Ronald¹; Gin, Tony²

Source: Neurological Research, Volume 28, Number 4, June 2006 , pp. 431-435(5)

Abstract:

Whereas advances in neurosurgical treatment and intensive care management improve the results from many of the devastating complications associated with aneurysmal subarachnoid hemorrhage, cerebral vasospasm remains a major cause of neurological morbidity and mortality. Experimental studies suggested that MgSO₄ inhibits excitatory amino acid release, blocks N-methyl-D-aspartate (NMDA) receptors and prevents calcium entry into the cell. Magnesium also increases red blood cell deformability. These changes may reduce the occurrence of cerebral vasospasm and minimize neuronal injury during episodes of cerebral vasospasm. Our group is currently hosting the intravenous magnesium sulfate to improve outcome after aneurysmal subarachnoid hemorrhage (IMASH) trial, which is a randomized, placebo-controlled, double-blinded, multicentered trial to evaluate the effect of magnesium sulfate infusion on the clinical outcome of patients with aneurysmal subarachnoid hemorrhage since 2002. The pilot result showed a trend towards decreased clinical vasospasm and better patient outcome. Magnesium sulfate infusion may prove to be an effective and inexpensive way to reduce the morbidity and mortality associated with aneurysmal subarachnoid hemorrhage, which is a major breakthrough in the current management.

Keywords: SUBARACHNOID HEMORRHAGE; INTRACRANIAL ANEURYSM; CEREBRAL VASOSPASM; MAGNESIUM

Document Type: Research article

DOI: 10.1179/016164106X115035

Affiliations: 1: Division of Neurosurgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China 2: Department of Anaesthesia and Intensive Care, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China

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Magnesium therapy within 48 hours of an aneurysmal subarachnoid hemorrhage: neuro-panacea