Effects of magnesium sulfate on the clinical course and GCS of patients with a severe diffuse axonal injury

BACKGROUND: Previous studies have shown that magnesium sulfate (MgSO4) administered in a patient with a diffuse axonal injury (DAI) can serve as a useful neuroprotective agent. The present study was conducted to examine whether magnesium sulfate has a therapeutic efficacy and safety in patients with a severe diffuse axonal injury. METHODS: Adult patients admitted within 1 hour of a closed Traumatic Brain Injury (TBI) with a severe diffuse axonal injury that met eligibility criteria were randomly selected and divided into two groups. Our treatment guidelines consisted of an initial loading dose of 50 mg/kg magnesium sulfate and then 50 mg/kg QID (quarter in die) up to 24 hours after the trauma. The outcome measures were mortality, Glasgow Coma Scale (GCS) score, and motor function scores which were assessed up to 2 months post-trauma. RESULTS: Magnesium showed a significant positive effect on GCS score at 2 months post-trauma (P=0.03). Motor functioning scores of patients in the MgSO4 group were higher than those in the control group but this was not statistically significant (P equal to 0.51). CONCLUSIONS: Findings of the present study demonstrated that administration of magnesium sulfate following severe DAI can have neuroprotective effect. KEYWORDS: Severe diffuse axonal injury, Magnesium sulfate, Outcome