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Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage

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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 MgSO4, 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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Authors and Affiliations

  1. Department of Intensive Care, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Maria Barile, Jean-Jacques Essama Mbia, Mijael Jativa & Philippe Hantson

  2. Department of Neurology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, , 1200, Brussels, Belgium

    Françoise van de Wyngaert

  3. Department of Neuroradiology, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Cécile Grandin

  4. Department of Neurosurgery, Cliniques Universitaires St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200, Brussels, Belgium

    Herbert Rooijakkers

Authors
  1. Maria Barile
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  2. Françoise van de Wyngaert
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  3. Jean-Jacques Essama Mbia
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  4. Mijael Jativa
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  5. Cécile Grandin
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  6. Herbert Rooijakkers
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  7. Philippe Hantson
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Corresponding author

Correspondence to Philippe Hantson.

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Barile, M., van de Wyngaert, F., Mbia, JJ.E. et al. Intravenous magnesium sulfate administration in a patient with refractory vasospasm following subarachnoid hemorrhage. Intensive Care Med 29, 1182–1185 (2003). https://doi.org/10.1007/s00134-003-1752-9

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  • DOI: https://doi.org/10.1007/s00134-003-1752-9

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