Background and Goal of Study: Vasospasm is the leading cause of disability and death from ruptured cerebral aneurysm. To determine the effect of nimodipine and magnesium sulphate in the treatment and prevention of cerebral vasospasm in subarachnoid hemorrhage (SAH) caused by the rupture of a cerebral aneurysm.
Patients and Methods: Two groups of patients were formed. Group I: patients to whome, in addition to the standard initial treatment and "3H therapy", nimodipine was administered at a dose of 15-30 mg/kg bw/h (3-10 ml) for the duration of the initial treatment. Group II: patients to whome, in addition to the standard initial treatment and "3H therapy" were administered with MgSO4 at a dose of 12 grams in 500 ml of 0.9% NaCl/24 h during the initial treatment (patients who had initial measures and intensive treatment to 12 days after the occurrence of SAH).
Results and Discussion: The progression of WFNS value (worsening of clinical condition) occurred in 30% of patients by observing both groups. There were no significant differences in progression of WFNS value during the initial treatment according to the groups (p=0.529). The worsening state of consciousness occurred in 32% of patients, measured by the GCS scale between the first and the tenth day, but there were no significant differences between groups (p=0.804). Regression analysis was applies, which included all potential predictors of outcome in the model. None of the parameters is not identified as a good predictor of the outcomes: WFNS (95% CI 0.52 to 6.95, OR=1.9, p=0.365), nimodipine therapy or magnesium sulfate (95% CI 0.29 to 8,79, OR=1.6, p=0.597). The research has confirmed the safety and feasibility of continuous infusion of high doses of intravenous MgSO4 in patients with aneurysmal subarachnoid haemorrhage (aSAH).
Conclusion: The outcome of the treatment 30 days after the occurrence of SAH, analyzed with the WFNS and GOS values, is not dependent on the method of prevention and treatment of vasospasm. Overall, calcium channel block reduce the risk of adverse outcomes.

The effect of nimodipine and magnesium sulfate in the treatment and prevention of cerebral vasospasm in subarachnoid hemorrhage caused by rupture of a cerebral aneurysm