Magnesium: potential roles in neurovascular disease.
OBJECTIVE
Magnesium therapy has been studied extensively in pre-clinical and clinical trials in multiple organ systems. Cerebrovascular diseases may benefit from its neuroprotective properties. This review summarizes current studies of magnesium in a wide range of neurovascular diseases.


METHODS
We searched relevant terms in the National Library of Medicine PubMed database and selected research including basic science, translational reports, meta-analyses, and clinical studies.


RESULTS
Studies examining magnesium administration in ischemic stroke have failed to show any benefit in clinical outcome. Data on magnesium for intracerebral hemorrhage (ICH) are limited. Preliminary investigations in subarachnoid hemorrhage (SAH) were promising, but definitive studies did not reveal differences in clinical outcome between magnesium and placebo-treated groups. Studies examining magnesium administration in global ischemia following cardiac arrest suggest a trend toward improved clinical outcome. The strongest evidence for clinically relevant neuroprotection following magnesium administration derives from studies of pre-term infants and patients undergoing cardiac bypass and carotid endarterectomy procedures. Magnesium was found to have an excellent safety profile across all investigations.


CONCLUSIONS
Magnesium is easy to administer and possesses a favorable safety profile. Its utility as a neuroprotectant in cardiac surgery, carotid endarterectomy, and pre-term infant hypoxia remain promising. Value as a therapeutic agent in ischemic stroke, ICH, and SAH is unclear and appears to be limited by late administration. Ongoing clinical trials assessing magnesium administration in the first hours following symptom onset may help clarify the role of magnesium therapy in these disease processes.
Department of Neurology, University of Southern California , Los Angeles, CA , USA.
Jason J
JJ
Chang
Department of Neurosurgery, University of Southern California , Los Angeles, CA , USA ; The Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California , Los Angeles, CA , USA.
William J
WJ
Mack
Department of Neurology, UCLA Stroke Center, University of California Los Angeles , Los Angeles, CA , USA.
Jeffrey L
JL
Saver
Department of Neurology, University of Southern California , Los Angeles, CA , USA ; The Roxanna Todd Hodges Comprehensive Stroke Clinic, University of Southern California , Los Angeles, CA , USA.
Nerses
N
Sanossian
all cerebrovascular disease/stroke; intracerebral hemorrhage; magnesium; neuroprotection; subarachnoid hemorrhage