gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Effects of intravenous magnesium sulfate in the treatment of aneurysmatic subarachnoid hemorrhage – a randomized study

Magnesiumsulfat in der Behandlung aneurysmatischer Subarachnoidalblutungen – eine randomisierte Studie

Meeting Abstract

  • corresponding author T. Westermaier - Neurochirurgische Klinik und Poliklinik, Universität Würzburg
  • C. Stetter - Neurochirurgische Klinik und Poliklinik, Universität Würzburg
  • J. Eriskat - Neurochirurgische Klinik und Poliklinik, Universität Würzburg
  • E. Kunze - Neurochirurgische Klinik und Poliklinik, Universität Würzburg
  • K. Roosen - Neurochirurgische Klinik und Poliklinik, Universität Würzburg

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocDO.05.01

The electronic version of this article is the complete one and can be found online at:

Published: April 11, 2007

© 2007 Westermaier et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Objective: Secondary ischemic deficits may cause major disability or death in patients with aneurysmatic subarachnoid hemorrhage. Calcium antagonists have long been subject of clinical and experimental studies regarding neuroprotection in cerebral vascular insults. Magnesium has shown beneficial effects in various experimental studies of cerebral ischemia. This study was performed to assess the protective efficacy of intravenous magnesium in subarachnoid hemorrhage.

Methods: 122 patients were enrolled in the study and were randomized to receive magnesium sulfate (therapeutic serum level 2.0 – 2.5 mmol/l) for at least 10 days or to serve as controls. All patients were treated by prophylactic hyperdynamic therapy, received transcranial Doppler sonography twice a day, and regular CT/Perfusion-CT. When signs of cerebral vasospasm were present, patients underwent cerebral angiography. Angioplasty was performed if spasms were accessible. Outcome parameters were secondary cerebral infarction and GOS after 6 months.

Results: 18 patients had to be excluded from the study. The use of magnesium in the dose used in this study did not cause major drug-related complications. In the magnesium group (n=52) 5 patients died in the course of treatment compared to 10 patients in the control group (n=53). In the magnesium group 62% (32 patients) reached an outcome of GOS 4 and 5 after 6 months compared to 51% (27 patients) in the control group. The incidence of vasospasm as determined by transcranial Doppler sonography and/or Perfusion-CT did not markedly differ between the two groups. However, the incidence of secondary cerebral infarction was lower in the magnesium group.

Conclusions: The use of intravenous magnesium sulfate – even in high doses – is safe and well controllable. Magnesium did not markedly inhibit the appearance of cerebral vasospasm. However, it seems to exert a neuroprotective effect in situations of compromised cerebral perfusion after aneurysmatic subarachnoid hemorrhage.