Magnesium Sulfate Effect on the Clinical Course and GCS of Patients with a Severe Diffuse Axonal Injury

Based on a number of studies, magnesium sulfate (MgSO4) given after a diffuse axonal injury has gained attention as a useful neuroprotective agent. The present study was conducted to examine if magnesium sulfate has a therapeutic efficacy and safety in patients with a severe diffuse axonal injury. Adult patients admitted within 1 hour of a closed Traumatic Brain Injury (TBI) with a severe diffuse axonal injury that met eligibility criteria were randomized into two groups. Our treatment guidelines consisted of an initial loading dose of 50 mg/kg magnesium sulfate and then 50 mg/kg QID up to 24 hours after the trauma. The outcome measures were mortality, GCS, and motor function scores which were assessed up to 2 months after the trauma. Magnesium showed a significant positive effect on GCS 2 months (P=0.03). Among those in MgSO4 group, motor functioning score improved more than control group but this was not statistically significant (P = 0.51). At the end, we have demonstrated that administration of magnesium sulfate can have neuroprotective role following severe DAI.