Magnesium

Hypomagnesemia is frequent after SAH and has been noted to be associated with the severity of vasospasm following aSAH. Moreover, hypomagnesemia between postbleed days 2 and 12 is predictive of DINDs (56). Magnesium might increase cerebral blood flow, reduce the contraction of cerebral arteries caused by various stimuli, and act as a nonspecific neuroprotectant (57). A prospective, randomized, single-blinded clinical trial of high-dose magnesium therapy following aSAH in 40 patients reported a trend (not statistically significant) in which a higher percentage of patients treated with magnesium attained GOS scores of 4 or 5 (compared to controls). As the authors suggest, a larger study is needed to evaluate this trend, as the power of this study is limited by an n of 40 (58).

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