Intravenous Magnesium Infusion for the Prevention of Symptomatic Cerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage.
10.3340/jkns.2012.52.2.75
- Author:
Jin Sue JEON
1
;
Seung Hun SHEEN
;
Gyojun HWANG
;
Suk Hyung KANG
;
Dong Hwa HEO
;
Yong Jun CHO
Author Information
1. Department of Neurosurgery, Hallym University College of Medicine, Chuncheon Sacred Heart Hospital, Chuncheon, Korea. neurosheen@gmail.com
- Publication Type:Original Article
- Keywords:
Cerebral vasospasm;
Subarachnoid hemorrhage;
Magnesium sulfate
- MeSH:
Aneurysm;
Case-Control Studies;
Cerebral Infarction;
Humans;
Incidence;
Magnesium;
Magnesium Sulfate;
Nimodipine;
Propensity Score;
Retrospective Studies;
Subarachnoid Hemorrhage;
Vasospasm, Intracranial
- From:Journal of Korean Neurosurgical Society
2012;52(2):75-79
- CountryRepublic of Korea
- Language:English
-
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.
