Effect of magnesium sulfate therapy on patients with aneurysmal subarachnoid hemorrhage using serum S100B protein as a prognostic marker

Abstract

Magnesium, one of the essential trace elements, plays important roles in maintaining both normal cellular and body functions. S100 calcium-binding protein B (S100B) has been used as a marker of glial damage in several neurological disorders. Thirty patients with ruptured intracranial aneurysms treated by clipping are included. The patients were randomized within 4 days after the attack of hemorrhage. The patients were divided into two groups with 15 patients in each group. Group I received magnesium infusion within 4 days. Group II is the control group. World Federation of Neurological Surgeons, Fisher, and Glasgow outcome scores are evaluated at an intensive care unit in addition to 3 months clinical follow-up evaluation. Samplings of serum S100B were performed on admission and on postoperative days 1, 3, and 7. There is a statistically significant difference between both groups as regards the second reading of the S100B (day 1 postoperative; P < 0.05). There is no statistically significant difference between both groups as regards outcome at 3 months using clinical status and S100B values. There is a tendency in the magnesium group to have better outcomes. Further studies with more number of patients with subarachnoid hemorrhage are needed to determinate the accuracy of S100B protein as a prognostic marker and of magnesium sulfate as a neuroprotector.

Biomarkers as outcome predictors in subarachnoid hemorrhage – a systematic review

“…S100β, neuron-specific enolase (NSE), glial fibrillary acid protein (GFAP), apolipoprotein E (apoE) and APOE gene, neurofilament, amyloid β-protein and ubiquitin C terminal hydrolase 1 (UCHL1) have been studied. Of these, S100β has been used as a prognostic adjunct tool, monitoring outcome following therapeutic treatment with magnesium and atorvastatin in SAH patients (Hassan et al, 2012; Schmid-Elsaesser et al, 2006). …”

Biomarkers of cerebral injury in cardiac surgery

“…Sevoflurane was likely associated with the worst cognitive outcome as assessed by neuropsychologic tests, as prolonged brain injury was seen with desflurane (24). Further studies on accuracy of S100B protein as a prognostic marker and of neuroprotective effect of magnesium sulfate remain to be demonstrated (25).…”

The role of magnesium sulfate in the intensive care unit

“…These injuries include stroke, aneurysmal subarachnoid hemorrhage (ASAH), and traumatic brain injuries (Afshari et al, 2013[2]; Akdemir et al, 2009[6]; Bradford et al, 2013[18]; Chan et al, 2005[23]; Chen et al, 2015[25]; Chen and Carter, 2011[27]; Dabbagh et al, 2006[30]; Dorhout Mees et al, 2012[33]; Friedlich et al, 2009[42]; Gao et al, 2013[45]; Gonzalez-Garcia et al, 2012[49]; Hassan et al, 2012[58]; James et al, 2009[69]; Jiang et al, 2017[71]; Johnson et al, 1993[72]; Kahraman et al, 2003[75]; Kidwell et al, 2009[79]; Kumar et al, 2015[85]; Lamers et al, 2003[87]; Lampl et al, 2001[88]; Mirrahimi et al, 2015[107]; Mousavi et al, 2004[109], 2010[110]; Muir and Lees, 1995[112]; Muir et al, 2004[113]; Muroi et al, 2008[114]; Rahimi-Bashar et al, 2017[122]; Rinosl et al, 2013[125]; Saver et al, 2015[132]; Selvaraj and Syed, 2014[136]; Singh et al, 2012[144]; Sleeswijk et al, 2008[146]; Stippler et al, 2006[148]; van den Bergh et al, 2005[156]; van Norden et al, 2005[157]; Veyna et al, 2002[158]; Wang et al, 2012[163]; Westermaier et al, 2010[166]; Wong et al, 2010[171]; Zafar et al, 2014[172]; Zhao et al, 2016[174]; Zhu et al, 2004[175]). …”

“…Effect of MgSO 4 on biomarkers in different neuropathies has been assessed in several studies (Bharosay et al, 2012[14]; Chan et al, 2005[23]; Friedlich et al, 2009[42]; Gao et al, 2013[45]; Gonzalez-Garcia et al, 2012[49]; Hassan et al, 2012[58]; James et al, 2009[69]; Johnson et al, 1993[72]; Lamers et al, 2003[87]; Mirrahimi et al, 2015[107]; Rahimi-Bashar et al, 2017[122]; Rinosl et al, 2013[125]). MgSO 4 was shown to decrease S100B levels with little side effects (Hassan et al, 2012[58]).…”

“…MgSO 4 was shown to decrease S100B levels with little side effects (Hassan et al, 2012[58]). The increase of biomarkers like S100B and S-SNE has been reported with serum Mg levels below 1.2 mmol/L, and is associated with poor outcomes and a higher rate of mortality in patients with stroke (James et al, 2009[69]; Mirrahimi et al, 2015[107]).…”