title: Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage.
abstract: 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.
authors.affiliation: Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium.
authors.forename: Maria
authors.initials: M
authors.lastname: Barile
authors.forename: Françoise
authors.initials: F
authors.lastname: van De Wyngaert
authors.forename: Jean-Jacques Essama
authors.initials: JJ
authors.lastname: Mbia
authors.forename: Mijael
authors.initials: M
authors.lastname: Jativa
authors.forename: Cécile
authors.initials: C
authors.lastname: Grandin
authors.forename: Herbert
authors.initials: H
authors.lastname: Rooijakkers
authors.forename: Philippe
authors.initials: P
authors.lastname: Hantson
mesh_terms: 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
chemical_list: D008278:Magnesium Sulfate