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Table 2 Randomized clinical studies investigating the therapeutic effect of intravenous magnesium to prevent delayed vasospasm and secondary ischemic events and to improve outcome after aneurysmal subarachnoid hemorrhage

From: Magnesium treatment for neuroprotection in ischemic diseases of the brain

Author Study setup Treatment arms and comedication Individuals Results
Luo et al., 1996 [50] Randomized, patient-blinded MgSO4 (approx. 100 – 200 mmol per day for 2 – 3 weeks) vs. placebo 52 patients Significant reduction of secondary neurological deterioration, reduction of delayed cerebral infarction
Veyna et al., 2002 [18] Randomized, patient-blinded Nimodipine vs. nimodipine + MgSO4 (25 mmol + 192 mmol/day for 10 days) 36 patients Safe use of magnesium. Non-significant trend to improved clinical outcome
Van den Bergh et al., 2005 [17] Randomized, double-blinded Nimodipine vs. nimodipine + MgSO4 (64 mmol/day for 14 days) 283 patients Reduction of delayed cerebral ischemia and trend to better neurological outcome
Schmid-Elsaesser et al., 2007 [51] Randomized, double-blinded Nimodipine vs. MgSO4 (10mg/kg + 30mg/kg/day for 7 days) 104 patients No significant difference between magnesium and nimodipine
Muroi et al., 2008 [21] Randomized, patient-blinded Nimodipine vs. nimodipine + MgSO4 (16 mmol + 64 mmol/24h, maximum serum concentration 2.0 mmil/l) 58 patients Trend to better clinical outcome after 3 and 12 months. Treatment was stopped in 16 patients due to hypotension, arrhythmias, respiratory arrest and myocardial infarction
Wong et al., 2010 [20] Randomized, double blinded Nimodipine vs. nimodipine + MgSO4 (20 mmol + 80 mmol/day for 14 days) 327 patients No reduction of secondary ischemia or outcome
Westermaier et al., 2010 [19] Randomized, double-blinded MgSO4 (141 ± 51 mmol – target serum level 2.0 – 2.5 mmol/l) vs. placebo 107 patients Significant reduction of secondary infarction and ultrasonographic/angiographic vasospasm. Non-significant reduction of neurological outcome and mortality
Mees et al., 2012 [52] Randomized, double-blinded Nimodipine vs. nimodipine + MgSO4 (64 mmol/day) 1207 patients No improvement of clinical outcome
  1. The results are not unequivocal. The beneficial effect might depend on the dose-regimen and comedication.