Evaluation of the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke

Background: Evidence is mounting that magnesium may play a critical role in the development of strokes and the healing process during and after a stroke. Magnesium is an N-methyl-D-aspartate (NMDA) glutamate receptor antagonist that has been shown to be neuroprotective in many preclinical models of ischemic and excitotoxic brain injury. This study was performed to evaluate the intravenous magnesium sulfate effect in clinical improvement of patients with acute ischemic stroke. Methods: One hundred and seven patients with acute ischemic stroke signs and symptoms lasting less than 12 hours were included in the study and were divided into two groups, 55 patients received 4 g of MgSO4 over 15 minutes and then 16 g over the next 24 hours, and 52 patients were received matching placebo. The study primary end point was stroke related neurologic deficit evaluation by the national institute of stroke scale (NIHSS). Results: Patients receiving MgSO4 showed significant recovery compared with the group of patients receiving placebo. Conclusion: This study suggests that magnesium sulfate can be used as a safe and useful neuroprotective agent in acute ischemic stroke and lacunar stroke patients may represent a relevant and practical target population for agents with biological activity in white matter. (c) 2012 Elsevier B.V. All rights reserved.