Magnesium sulfate: role as possible attenuating factor in vasospasm morbidity.
BACKGROUND
Among the many complications of SAH, one of the most important is vasospasm. Several treatment alternatives have been proposed for this condition, with far-from-ideal results being obtained. Magnesium sulfate recently returned to the scene (with still unproven benefit) as an adjuvant in the treatment of vasospasm.


METHODS
Seventy-two patients diagnosed with SAH by aneurysm rupture were submitted to microsurgery craniotomy and subdivided in 2 groups. Group 1, formed by 48 patients, received prophylactic hypervolemic and hemodilution therapy in addition to nimodipine. Group 2, composed of 24 patients, received the same treatment of group 1 with the addition of magnesium sulfate in continuous infusion from 120 to 150 mg a day, keeping serum magnesium levels close to double normal values.


RESULTS
Age was 49 +/- 12.6 years. Ratio of female to male was 3.16:1. Most patients were admitted in a Hunt-Hess grade 2 (46.4%) and Fisher grade 3 (52.8%). Anterior communicating artery aneurysms were the most common in location (38.8%). Both groups were compared, and there was no statistical difference related to age, sex, and Glasgow, Fisher, or Hunt-Hess admission grades. No statistical difference in vasospasm incidence was found between the two groups. However, in group 1, vasospasm was correlated with a longer hospitalization time (P = .0003), different from group 2, in which patients with vasospasm receiving magnesium sulfate required less hospitalization time.


CONCLUSIONS
Magnesium did not seem to interfere in vasospasm frequency but apparently acted favorably in decreasing morbidity and length of hospital stay.
Prevedello
Daniel Monte-Serrat
DM
Department of Neurosurgery, Hospital Nossa Senhora das Graças, Curitiba, Paraná 80810-040, Brazil.
Cordeiro
Joacir Graciolli
JG
de Morais
Andrei Leite
AL
Saucedo
Nestor Saucedo
NS
Chen
Iara B
IB
Araújo
João Cândido
JC
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D003399:Craniotomy; D005260:Female; D006801:Humans; D007902:Length of Stay; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000401:mortality / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome; D020301:Vasospasm, Intracranial / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality*
D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate