J Korean Neurosurg Soc.  2012 Aug;52(2):75-79. 10.3340/jkns.2012.52.2.75.

Intravenous Magnesium Infusion for the Prevention of Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage

• Jeon JS
• Sheen SH
• Hwang G
• Kang SH
• Heo DH
• Cho YJ

• KMID: 2190542
• DOI: http://doi.org/10.3340/jkns.2012.52.2.75

Abstract

OBJECTIVE
The study examined the difference in the incidence of symptomatic cerebral vasospasm with magnesium supplementation in aneurysmal subarachnoid hemorrhage (SAH) in a Korean population.
METHODS
This retrospective analysis was performed in 157 patients diagnosed with aneurysmal SAH from January 2007 to December 2011 at a single center. Seventy patients (44.6%) received a combination treatment of nimodipine with magnesium and 87 patients (55.4%) received only nimodipine. A matched case-control study using propensity scores was conducted and 41 subjects were selected from each group. A dosage of 64 mmol/day of magnesium was administrated.
RESULTS
The infusion of magnesium did not reduce the incidence of symptomatic cerebral vasospasm (n=7, 17.1%, p=0.29) compared with simple nimodipine injection (n=11, 26.8%). The ratios of good clinical outcome (modified Rankin scale 0-2) at 6 months were similar, being 78% in the combination treatment group and 80.5% in the nimodipine only group (p=0.79). The proportions of delayed cerebral infarction was not significantly lower in patients with combination treatment (n=2, 4.9% vs. n=3, 7.3%; p=0.64). There was no difference in the serum magnesium concentrations between the patients with symptomatic vasospasm and without vasospasm who had magnesium supplementation. No major complications associated with intravenous magnesium infusion were observed.
CONCLUSION
Magnesium supplementation (64 mmol/day) may not be beneficial for the reduction of the incidence of symptomatic cerebral vasospasm in patients with aneurysmal SAH.

Keyword

Cerebral vasospasm; Subarachnoid hemorrhage; Magnesium sulfate

MeSH Terms

Aneurysm
Case-Control Studies
Cerebral Infarction
Humans
Incidence
Magnesium
Magnesium Sulfate
Nimodipine
Propensity Score
Retrospective Studies
Subarachnoid Hemorrhage
Vasospasm, Intracranial
Magnesium
Magnesium Sulfate
Nimodipine

Figure

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  Fig. 1 Flow diagram of enrolled patients.

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  Fig. 2 Repeated serum concentrations of magnesium between the patients with symptomatic vasospasm and without vasospasm who had magnesium infusion. There was no difference in the serum concentrations of magnesium between the two groups (p=0.50).

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