Document Detail

Magnesium sulfate in the management of patients with Fisher Grade 3 subarachnoid hemorrhage: a pilot study.
MedLine Citation:
PMID:  10981747     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effect of magnesium sulfate (MgSO4) on the clinical course of patients with severe aneurysmal subarachnoid hemorrhage (SAH). METHODS: Ten patients with Fisher Grade 3 aneurysmal SAH were evaluated. The patients were given a bolus as well as a constant infusion of intravenous MgSO4 up to 10 days postictus. Blood magnesium levels were obtained to adjust the daily requirement of MgSO4. The goal was to raise the serum level to 2.0 to 2.5 mmol/L or twice the baseline serum level. Daily transcranial Doppler (TCD) ultrasonography was performed on each patient, insonating both anterior cerebral and middle cerebral arteries. Further management followed standard protocols, including the use of nimodipine and hypervolemic therapy. TCD ultrasonographic findings, as well as clinical evidence of cerebral vasospasm, were documented. All patients had a 3-month assessment using the Glasgow Outcome Scale. RESULTS: After administration of a 20 mmol MgSO4 bolus infusion and an average daily continuous infusion of 84.7 mmol, 8 of 10 patients achieved the predetermined serum magnesium levels. No adverse affects were noted during the infusions. Five patients exhibited evidence of vasospasm on TCD ultrasonography; vasospasm was severe in two patients (velocities, >200 cm/s). Three patients, including the two patients in whom TCD ultrasonography demonstrated severe vasospasm, exhibited clinical evidence of vasospasm. Two patients had a Glasgow Outcome Scale score of 3; the remainder had Glasgow Outcome Scale scores of 5. CONCLUSION: Administration guidelines for the use of MgSO4 in aneurysmal SAH were established. A prospective double-blind placebo-controlled trial is required to establish the effectiveness of MgSO4 for treating vasospasm in aneurysmal SAH.
R Boet; E Mee
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Neurosurgery     Volume:  47     ISSN:  0148-396X     ISO Abbreviation:  Neurosurgery     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2001-02-02     Completed Date:  2001-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  602-6; discussion 606-7     Citation Subset:  IM    
Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, New Territories.
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MeSH Terms
Blood Flow Velocity / drug effects
Dose-Response Relationship, Drug
Drug Administration Schedule
Drug Therapy, Combination
Glasgow Outcome Scale
Infusions, Intravenous
Intracranial Aneurysm / surgery*,  ultrasonography
Magnesium Sulfate / administration & dosage*
Middle Aged
Pilot Projects
Postoperative Complications / classification,  drug therapy*,  ultrasonography
Subarachnoid Hemorrhage / classification,  surgery*,  ultrasonography
Treatment Outcome
Ultrasonography, Doppler, Transcranial
Vasospasm, Intracranial / classification,  drug therapy*,  ultrasonography
Reg. No./Substance:
7487-88-9/Magnesium Sulfate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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