Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage.
OBJECTIVE
Magnesium sulfate is being investigated for the prevention or treatment of vasospasm following subarachnoid hemorrhage.


METHODS
A 45-year-old woman suffered subarachnoid hemorrhage and developed after 8 days symptomatic vasospasm in the left middle cerebral artery (MCA) while she was receiving nimodipine prophylactically.


RESULTS
Transcranial Doppler monitoring was performed. Cerebral autoregulation was abolished in the left MCA. Despite this finding the administration of a bolus dose of MgSO(4), followed by a continuous infusion in order to achieve serum magnesium levels in the range of 4-4.5 mg/dl (1.65-1.85 mmol/l), resulted in a marked decrease (12.2%) of the left MCA mean blood flow velocity, without clinically relevant change in systemic blood pressure (3%). This effect was maintained for at least 4 h. It did not prevent the development of ischemic lesions.
Barile
Maria
M
Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium.
van De Wyngaert
Françoise
F
Mbia
Jean-Jacques Essama
JJ
Jativa
Mijael
M
Grandin
Cécile
C
Rooijakkers
Herbert
H
Hantson
Philippe
P
D001530:Belgium; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013345:Subarachnoid Hemorrhage / Q000150:complications* / Q000503:physiopathology; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology
D008278:Magnesium Sulfate