{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T07:16:50Z","timestamp":1778224610413,"version":"3.51.4"},"reference-count":17,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2002,3]]},"abstract":"<jats:p content-type=\"fine-print\"><jats:italic>Object.<\/jats:italic> Vasospasm remains a significant source of neurological morbidity and mortality following aneurysmal subarachnoid hemorrhage (SAH), despite advances in current medical, surgical, and endovascular therapies. Magnesium sulfate therapy has been demonstrated to be both safe and effective in preventing neurological complications in obstetrical patients with eclampsia. Evidence obtained using experimental models of brain injury, cerebral ischemia, and SAH indicate that Mg may also have a role as a neuroprotective agent. The authors hypothesize that MgSO<jats:sub>4<\/jats:sub> therapy is safe, feasible, and has a beneficial effect on vasospasm and, ultimately, on neurological outcome following aneurysmal SAH.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Methods.<\/jats:italic> A prospective randomized single-blind clinical trial of high-dose MgSO<jats:sub>4<\/jats:sub> therapy following aneurysmal SAH (Hunt and Hess Grades II\u2013IV) was performed in 40 patients, who were enrolled within 72 hours following SAH and given intravenous MgSO<jats:sub>4<\/jats:sub> or control solution for 10 days. Serum Mg<jats:sup>++<\/jats:sup> levels were maintained in the 4 to 5.5 mg\/dl range throughout the treatment period. Clinical management principles were the same between groups (including early use of surgery or endovascular treatment, followed by aggressive vasospasm prophylaxis and treatment). Daily transcranial Doppler (TCD) ultrasonographic recordings were obtained, and clinical outcomes were measured using the Glasgow Outcome Scale (GOS). The patients' GOS scores and the TCD recordings were analyzed using the independent t-test.<\/jats:p>\n<jats:p content-type=\"fine-print\">Forty patients were enrolled in the study: 20 (15 female and five male patients) received treatment and 20 (11 female and nine male patients) comprised a control group. The mean ages of the patients in these groups were 46 and 51, respectively, and the mean clinical Hunt and Hess grades were 2.6 \u00b1 0.68 in the MgSO<jats:sub>4<\/jats:sub> treatment group and 2.3 \u00b1 0.73 in the control group (mean \u00b1 standard deviation [SD], p = 0.87). Fisher grades were similar in both groups. Mean middle cerebral artery velocities were 93 \u00b1 27 cm\/second in MgSO<jats:sub>4<\/jats:sub>-treated patients and 102 \u00b1 34 cm\/second in the control group (mean \u00b1 SD, p = 0.41). Symptomatic vasospasm, confirmed by angiography, occurred in six of 20 patients receiving MgSO<jats:sub>4<\/jats:sub> and in five of 16 patients receiving placebo. Mean GOS scores were 3.8 \u00b1 1.6 and 3.6 \u00b1 1.5 (mean \u00b1 SD, p = 0.74) in the treatment and control groups, respectively. Significant adverse effects from treatment with MgSO<jats:sub>4<\/jats:sub> did not occur.<\/jats:p>\n<jats:p content-type=\"fine-print\"><jats:italic>Conclusions.<\/jats:italic> Administration of high-dose MgSO<jats:sub>4<\/jats:sub> following aneurysmal SAH is safe, and steady Mg<jats:sup>++<\/jats:sup> levels in the range of 4 to 5.5 mg\/dl are easily maintained. This treatment does not interfere with neurological assessment, administration of anesthesia during surgery, or other aspects of clinical care. We observed a trend in which a higher percentage of patients obtained GOS scores of 4 or 5 in the group treated with MgSO<jats:sub>4<\/jats:sub>, but the trend did not reach a statistically significant level. A larger study is needed to evaluate this trend further.<\/jats:p>","DOI":"10.3171\/jns.2002.96.3.0510","type":"journal-article","created":{"date-parts":[[2009,5,13]],"date-time":"2009-05-13T17:48:55Z","timestamp":1242236935000},"page":"510-514","source":"Crossref","is-referenced-by-count":162,"title":["Magnesium sulfate therapy after aneurysmal subarachnoid hemorrhage"],"prefix":"10.3171","volume":"96","author":[{"given":"Richard S.","family":"Veyna","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Seyfried","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Don G.","family":"Burke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Zimmerman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Mlynarek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victoria","family":"Nichols","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Marrocco","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ajith J.","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Panayiotis D.","family":"Mitsias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ghaus M.","family":"Malik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"key":"b1","series-title":"N Engl J Med","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1056\/NEJM198303173081103","article-title":"Cerebral arterial spasm\u2014a controlled trial of nimodipine in patients with subarachnoid hemorrhage.","volume":"308","author":"Allen","year":"1983"},{"key":"b2","series-title":"Prog Cardiovasc Dis","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1016\/0033-0620(93)90008-2","article-title":"Magnesium and cardiovascular disease.","volume":"35","author":"Arsenian","year":"1993"},{"key":"b3","series-title":"Muscle Nerve","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1002\/mus.880130808","article-title":"Myesthenia gravis presenting as weakness after magnesium administration.","volume":"13","author":"Bashuk","year":"1990"},{"key":"b4","series-title":"Neurosurgery","first-page":"602","article-title":"Magnesium sulfate in the management of patients with Fisher Grade 3 subarachnoid hemorrhage: a pilot study.","volume":"47","author":"Boet","year":"2000"},{"key":"b5","series-title":"Lancet","first-page":"480","article-title":"Assessment of outcome after severe brain damage. 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