Study Shows No Benefit In Using Magnesium Sulphate Treatment For Hemorrhagic Stroke

13% of stroke cases are hemorrhagic strokes.

Hemorrhagic strokes happen when a blood vessel in the brain ruptures and bleeds into its surroundings. The blood then accumulates and compresses the surrounding tissues of the brain. There are two types of hemorrhagic strokes: intracerebral hemorrhage or subarachnoid hemorrhage.

Intracerebral hemorrhage occurs when the blood from the burst vessel leaks inside the brain. A subarachnoid hemorrhage is when the bleeding is in the area between the brain and the thin tissues that cover the brain.

There are two types of weakened blood vessels usually cause hemorrhagic stroke: aneurysms and arteriovenous malformations (AVMs). When a weakened area of a blood vessel starts to balloon, an aneurysm happens. If the aneurysm is left untreated, it will eventually rupture and bleed into the brain. An AVM on the other hand, is a group or cluster of abnormally formed blood vessels. These blood vessles can rupture and cause a hemorrhagic stroke.

Magnesium sulphate is believed to improve the outcome of an aneurysmal subarachnoid hemorrhage. It does so by reducing the occurrence or improving the outcome of delayed cerebral ischaemia. This type of treatment has been debated as to its usefulness and effectiveness.

Study should end debate over magnesium treatment for preventing poor outcome after hemorrhagic stroke

An international randomised trial and meta-analysis published Online First in The Lancet should put an end to the debate about the use of intravenous magnesium sulphate to prevent poor outcomes after hemorrhagic stroke. The investigators found no benefit from magnesium treatment compared with placebo.

"The findings from MASH 2 have important implications for clinical practice. Administration of magnesium is standard practice in many centres", explains Sanne Dorhout Mees* from University Medical Center Utrecht, Netherlands, who led the research.

Endovascular Aneurysm Repair (EVAR) Provides Safe and Effective Aneurysm Treatment

An emergency treatment that is minimally invasive can effectively treat ruptured abdominal aneurysms with less recovery time, no major surgery and fewer discharges to in-patient care facilities.

An abdominal aortic aneurysm is a condition when the large blood vessel that supplies blood to the abdomen, pelvis, and legs grows abnormally large or balloons outward. It can be fatal once the blood vessel ruptures.

Abdominal Aortic Aneurysms develop slowly over many years and do not show any outward symptoms. Once the aneurysm expands rapidly, ruptures, or leaks blood along the blood vessl walls, symptoms will develop suddenly such as:

• Severe, sudden, persistent, or constant pain in the abdomen or back which may radiate to the groin, buttocks, or legs.
• Clammy skin
• Nausea and vomiting
• Rapid heart rate
• Shock

Although the cause for aneurysms are unknown, factors that may raise the risk of abdominal aneurysms are:

• Smoking
• High blood pressure
• High cholesterol
• Emphysema
• Genetic factors
• Obesity

Males are more likely to suffer abdominal aneurysm than women.

A burst aneurysm (a local area of bulge) in the abdominal aorta—the largest blood vessel in the body— is a deadly condition. In fact, about half of these patients don't make it to the hospital in time. Those who do more often than not face open surgery to repair the blood vessel. This study finds that a minimally invasive interventional radiology treatment for ruptured aneurysms called endovascular aneurysm repair (EVAR) is safer than open surgical repair and is associated with lower mortality rates, say researchers Society of Interventional Radiology's 37th Annual Scientific Meeting in San Francisco, Calif.

Abdominal aortic aneurysm is a local area of bulge or dilatation in the abdominal aorta. If left untreated, this bulge can increase in size and—after reaching a certain size--it can burst or rupture causing fatal internal bleeding. In the United States, 9 percent of the population over the age of 65 years has an abdominal aortic aneurysm, and there are 15,000 deaths per year from ruptured abdominal aortic aneurysms. A man is four times more likely to suffer an aneurysm of this kind than a woman, and smokers are also four times as likely to develop the condition.

"People with peripheral arterial disease are at risk of an aneurysm, which is a weakening and abnormal bulging of a major artery. Once this area of bulge ruptures, this can lead to fatal internal hemorrhage," explained Prasoon Mohan, M.D., co-author of the study from the department of diagnostic and interventional radiology at Saint Francis Hospital in Evanston, Ill. "Prior to the development of minimally invasive endovascular repair, it was customary for individuals to undergo open surgery, but now the majority of these elective aneurysm repairs are being done by endovascular technique. It's only a question now of getting clinicians and institutions to use the same technique in emergency settings for ruptured aneurysms," he added.