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 |