Magnesium: a useful adjunct in the prevention of cerebral vasospasm following aneurysmal subarachnoid haemorrhage.
Despite recent advances in the management of aneurysmal subarachnoid haemorrhage delayed ischaemic deficits from cerebral vasospasm remains a major cause of morbidity and mortality. As magnesium is a potent cerebral vasodilator we have introduced routine supplementation in patients presented with subarachnoid haemorrhage to determine whether there has been a reduction in the incidence of cerebral vasospasm.


METHODS
All patients presented with aneurysmal subarachnoid haemorrhage from February 1997 were included except those who presented after day 5 following bleed. Identical management protocol was used except intravenous magnesium supplementation which was introduced to all patients from May 1999. Incidence of cerebral vasospasm on angiograms among the two groups was analysed.


RESULTS
Seven out of 10 patients who did not receive magnesium supplement developed vasospasm requiring intra-arterial papaverine compared with 2 of 13 patients among the treated group (P<0.008).


CONCLUSIONS
From our pilot study it appears that magnesium supplement has a beneficial role in the prevention of cerebral vasospasm following aneurysmal subarachnoid haemorrhage. Further studies would seem justified.
Chia
R Y
RY
Dalcross Private Hospital, Killara, The University of Sydney, Australia. rytc@bigpond.com
Hughes
R S
RS
Morgan
M K
MK
D000328:Adult; D000368:Aged; D002533:Cerebral Angiography; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D007275:Injections, Intravenous; D002532:Intracranial Aneurysm / Q000150:complications*; D008274:Magnesium / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010208:Papaverine / Q000008:administration & dosage / Q000627:therapeutic use; D010865:Pilot Projects; D013345:Subarachnoid Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D020301:Vasospasm, Intracranial / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control*
D014665:Vasodilator Agents; D010208:Papaverine; D008274:Magnesium