Early Intravenous Magnesium Sulfate and Its Impact on Cerebral Vasospasm as well as Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage: A Retrospective Matched Case-Control Analysis

Feulner J, Weidinger C, Dörfler A, Birkholz T, Buchfelder M, Sommer B (2024)

Publication Type: Journal article

Publication year: 2024

Journal

World Neurosurgery Elsevier

Book Volume: 186

Pages Range: e106-e113

DOI: 10.1016/j.wneu.2024.03.062

Abstract

Background: Magnesium sulfate (MgSO4) is a potential neuroprotective agent for patients with aneurysmal subarachnoid hemorrhage (SAH). We analyzed the effect of early application of intraoperative intravenous MgSO4 and compared cerebral vasospasm (CV), delayed cerebral ischemia (DCI), and neurological outcome in 2 patient cohorts. Methods: A retrospective matched-pair analysis from patients at a single center in Germany was performed without (group A) and with (group B) MgSO4 application <24 hours after diagnosis. Pairs were matched according to the known risk factors for DCI and CV (age, Fisher grade, smoking, severity of SAH). Incidence of CV and DCI and neurological outcome using the modified Rankin Scale score 3 and 12 months after SAH were recorded. Results: The inclusion criteria were met by 196 patients. After risk stratification, 48 patients were included in the final analysis (age 54.2 ± 8.1 years; 30 women and 18 men) and were assigned to group A (n = 24) or group B (n = 24). CV occurred less frequently in group B (33%) than in group A (46%). Likewise, DCI was present in 13% in group B compared with 42% in group A. After 12 months, 22 patients in group B had a favorable functional outcome (modified Rankin Scale score 0–3) compared with 15 patients in group A. Conclusions: In this study, the incidence of CV and DCI was lower in patients receiving intravenous MgSO4 within 24 hours after aneurysmal SAH onset. Favorable functional outcome was more likely in the MgSO4 group after 12 months of follow-up.

Authors with CRIS profile

Julian Feulner Lehrstuhl für Innere Medizin V Cornelia Weidinger Department of Anaesthesiology Arnd Dörfler Department of Neuroradiology Torsten Birkholz Department of Anaesthesiology Michael Buchfelder Lehrstuhl für Neurochirurgie Björn Sommer Medizinische Fakultät

How to cite

APA:

Feulner, J., Weidinger, C., Dörfler, A., Birkholz, T., Buchfelder, M., & Sommer, B. (2024). Early Intravenous Magnesium Sulfate and Its Impact on Cerebral Vasospasm as well as Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage: A Retrospective Matched Case-Control Analysis. World Neurosurgery, 186, e106-e113. https://doi.org/10.1016/j.wneu.2024.03.062

MLA:

Feulner, Julian, et al. "Early Intravenous Magnesium Sulfate and Its Impact on Cerebral Vasospasm as well as Delayed Cerebral Ischemia in Aneurysmal Subarachnoid Hemorrhage: A Retrospective Matched Case-Control Analysis." World Neurosurgery 186 (2024): e106-e113.

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