Magnesium sulphate for aneurysmal subarachnoid hemorrhage: why, how, and current controversy.
The neuroprotective effect of magnesium sulphate infusion has been confirmed in experimental models. Pilot clinical trials using magnesium sulphate in patients with acute aneurysmal subarachnoid hemorrhage (SAH) have reported a trend toward a reduction in clinical deterioration due to delayed cerebral ischemia (DCI) and an improvement in clinical outcomes. However, our recent multicenter trials and systemic review failed to confirm benefit in neurological outcome. In post hoc analysis, data also did not support that a higher dose of magnesium sulphate infusion might improve clinical outcome. We here review the current literature, highlight these discrepancies, and explore alternatives.
The Chinese University of Hong Kong, Shatin, Hong Kong, China. georgewong@surgery.cuhk.edu.hk
George Kwok Chu
GK
Wong
Wai Sang
WS
Poon
D002545:Brain Ischemia / Q000209:etiology* / Q000517:prevention & control*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D004333:Drug Administration Routes; D006801:Humans; D008278:Magnesium Sulfate / Q000008:administration & dosage*; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000188:drug therapy*
D002121:Calcium Channel Blockers; D008278:Magnesium Sulfate