• Daniel Friedlich, Celso Agner, Alan S Boulos, Fasil Mesfin, Paul Feustel, Gary L Bernardini, and A John Popp.
• Department of Surgery, Division of Neurosurgery, Albany Medical Center, Albany, NY, USA.
• Neurol. Res. 2009 Jul 1; 31 (6): 621-5.

ObjectiveExperimental work suggests a neuroprotective role for magnesium sulfate in aneurysmal subarachnoid hemorrhage. We retrospectively review the incidence of clinically relevant vasospasm in patients treated or not with continuous magnesium infusion after onset of subarachnoid hemorrhage.MethodsAll patient records in Albany Medical Center with the diagnosis of SAH between January 1999 and June 2004 were reviewed. Patients who presented to the emergency department within 72 hours of onset were entered in the study. Patients were defined as in clinical vasospasm if there was an acute neurological change in association with abnormal trancranial Doppler (TCD), CT angiogram (CTA) or digital subtraction angiography (DSA).ResultsA total of 85 patients were selected. Magnesium sulfate was infused in 43 patients. When compared with patients who did not receive MgSO(4), there was a statistically significant lower incidence of clinical and radiological vasospasm in those who had the continuous infusion of magnesium sulfate (p<0.01). There was no statistically significant difference between patients who were coiled or clipped.ConclusionContinuous magnesium sulfate infusion for the management of clinically significant cerebral vasospasm is safe and reduces the incidence of clinically significant cerebral vasospasm. Large, multicenter, controlled studies should be performed in order to determine the true effectiveness of the treatment in a controlled setting.

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