The role of magnesium sulfate in the treatment of vasospasm in patients with spontaneous subarachnoid haemorrhage

Kostas N. Fountas, T. G. MacHinis, J. S. Robinson, C. Sevin, N. I. Fezoulidis, M. Castresana, E. Z. Kapsalaki

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Abstract

The vasodilatory effect of magnesium sulfate (MgSO4) in cerebral vessels has been previously demonstrated. Our prospective, randomized study assessed the effect of MgSO4 in the treatment of vasospasm in patients with spontaneous subarachnoid haemorrhage (SAH). Seventy-four patients with SAH were randomly divided into 3 groups. In Group A, only nimodipine was administered; in Group B, only MgSO4 was given; and in Group C, both nimodipine and MgSO4 were administered. Daily TransCranial Doppler (TCD) measurements of the anterior (ACA) and middle (MCA) cerebral arteries were subsequently obtained. Glasgow Outcome Scale (GOS) scores, hospital stay length, and the cost of treatment were tracked and calculated. Mean flow velocity measurements for ACA and MCA were calculated. Differences between Groups A and B, and Groups A and C (p= 0.0013, 0.0011, respectively) were statistically significant. The mean GOS scores were: Group A, 3.8; Group B, 4.4; and Group C, 4.1. The mean lengths of stay were: Group A, 11.8 ± 0.2 days; Group B, 11.5 ± 0.2 d; and Group C, 11.3 ± 0.1 d. The cost of treatment was similar between all groups. Intravenous MgSO4 significantly decreases cerebral flow velocities. Administration of MgSO 4 improved our patients' outcomes and reduced the length of their hospital stay. Our preliminary results justify the need for a large, randomized multi-institutional study.

Original languageEnglish (US)
Title of host publicationCerebral Vasospasm
Subtitle of host publicationNew Strategies in Research and Treatment
PublisherSpringer-Verlag Wien
Pages269-273
Number of pages5
Edition104
ISBN (Print)9783211757178
DOIs
Publication statusPublished - Jan 1 2008

Publication series

NameActa Neurochirurgica, Supplementum
Number104
ISSN (Print)0065-1419

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Keywords

  • Cost of treatment
  • magnesium sulfate
  • outcome
  • subarachnoid haemorrhage
  • transcranial doppler
  • vasospasm

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Fountas, K. N., MacHinis, T. G., Robinson, J. S., Sevin, C., Fezoulidis, N. I., Castresana, M., & Kapsalaki, E. Z. (2008). The role of magnesium sulfate in the treatment of vasospasm in patients with spontaneous subarachnoid haemorrhage. In Cerebral Vasospasm: New Strategies in Research and Treatment (104 ed., pp. 269-273). (Acta Neurochirurgica, Supplementum; No. 104). Springer-Verlag Wien. https://doi.org/10.1007/978-3-211-75718-5_55