Magnesium sulphate for aneurysmal subarachnoid hemorrhage: why, how, and current controversy.
ACTA NEUROCHIRURGICA. SUPPLEMENT 2013;
115:45-8. [PMID:
22890642 DOI:
10.1007/978-3-7091-1192-5_10]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
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