Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage.
(2003) Intensive care medicine — Vol. 29, n° 7, p. 1182-1185 (2003)
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- Abstract
- OBJECTIVE: Magnesium sulfate is being investigated for the prevention or treatment of vasospasm following subarachnoid hemorrhage. PATIENT: A 45-year-old woman suffered subarachnoid hemorrhage and developed after 8 days symptomatic vasospasm in the left middle cerebral artery (MCA) while she was receiving nimodipine prophylactically. METHODS AND RESULTS: Transcranial Doppler monitoring was performed. Cerebral autoregulation was abolished in the left MCA. Despite this finding the administration of a bolus dose of MgSO(4), followed by a continuous infusion in order to achieve serum magnesium levels in the range of 4-4.5 mg/dl (1.65-1.85 mmol/l), resulted in a marked decrease (12.2%) of the left MCA mean blood flow velocity, without clinically relevant change in systemic blood pressure (3%). This effect was maintained for at least 4 h. It did not prevent the development of ischemic lesions.
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Barile, M., van de Wyngaert, F., Mbia, J.-J. E., Jativa, M., Grandin, C., Rooijakkers, H., & Hantson, P. (2003). Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage. Intensive care medicine, 29(7), 1182-1185. https://doi.org/10.1007/s00134-003-1752-9 (Original work published 2003)