Hypomagnesemia after ruptured middle cerebral artery aneurysms: Predictive factor and pathophysiological implication

Abstract

Hypomagnesemia was frequently present after aneurysmal subarachnoid haemorrhage. It was found in 38% of patients admitted after aneurysmal SAH and predicted the occurrence of delayed cerebral ischemia. The pathophysiology was not clear from the literature. We investigated the incidence and the predictive factor of hypomagnesemia in twenty two patients with ruptured middle cerebral artery aneurysms. Hypomagnesemia on admission was present in 36% of patients. The presence of Sylvian fissure hematoma with midline shift, but not initial neurological status, such as WFNS grades 1-3 versus 4-5 on admission predicted hypomagnesemia. The possible pathophysiology was uncertain and might be due to an acute intracellular shift of magnesium. © 2008 Springer-Verlag.