***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: BACKGROUND Recent studies suggest that high-dose MgSO4 therapy is safe and reduces the incidence of DIND and subsequent poor outcome after SAH . We intended to assess the safety and efficacy of high-dose MgSO4 therapy after SAH as means to prevent DIND and to evaluate the impact on clinical outcome . METHODS This was a prospect i ve , r and omized , single-blind , placebo-controlled study . The MgSO4 infusion was adjusted every 12 hours until day 12 according to the target serum Mg2 + level . The occurrence of DIND , secondary infa rct ion , side effects , and the outcome after 3 and 12 months were assessed . RESULTS Fifty-eight patients were r and omized ; 27 received placebo and 31 MgSO4 .  The difference in occurrence of DIND and secondary infa rct ion was not significant . The intention-to-treat analysis revealed a trend toward better outcome ( P = .083 ) after 3 months . On-treatment analysis showed a significantly better outcome after 3 months ( P = .017 ) and a trend toward better outcome after 1 year ( P = .083 ) . Significantly more often hypotension ( P = .040 ) and hypocalcemia ( P = .005 ) occurred as side effects in the treatment group . In 16 patients ( 52 % ) , the MgSO4 therapy had to be stopped before day 12 because of side effects . No predictive factor leading to termination was found in a postr and omization analysis . CONCLUSIONS High-dose MgSO4 therapy might be efficient as a prophylactic adjacent therapy after SAH to reduce the risk for poor outcome . Nevertheless , because of the high frequency of the side effects , patients should be observed in an intensive or intermediate care setting Background and Purpose — Pilot clinical trials using magnesium sulfate in patients with acute aneurysmal subarachnoid hemorrhage have reported trends toward improvement in clinical outcomes . This Phase III study aim ed to compare intravenous magnesium sulfate infusion with saline placebo among such patients . Methods — We recruited patients with aneurysmal subarachnoid hemorrhage within 48 hours of onset from 10 participating centers . The patients were r and omly assigned to magnesium sulfate infusion titrated to a serum magnesium concentration twice the baseline concentration or saline placebo for 10 to 14 days . Patients and assessors were blinded to treatment allocation . The study is registered at www.strokecenter.org/trials ( as Intravenous Magnesium Sulphate for Aneurysmal Subarachnoid Hemorrhage [ IMASH ] ) and www . Clinical Trials.gov ( NCT00124150 ) . Results — Of the 327 patients recruited , 169 were r and omized to receive treatment with intravenous magnesium sulfate and 158 to receive saline ( placebo ) .  The proportions of patients with a favorable outcome at 6 months ( Extended Glasgow Outcome Scale 5 to 8) were similar , 64 % in the magnesium sulfate group and 63 % in the saline group ( OR , 1.0 ; 95 % CI , 0.7 to 1.6 ) . Secondary outcome analyses ( modified Rankin Scale , Barthel Index , Short Form 36 , and clinical vasospasm ) also showed no significant differences between the 2 groups . Predefined subgroups included age , admission World Federation of Neurological Surgeons grade , pre-existing hypertension , intracerebral hematoma , intraventricular hemorrhage , location of aneurysm , size of aneurysm , and mode of aneurysm treatment . In none of the subgroups did the magnesium sulfate group show a better outcome at 6 months . Conclusions — The results do not support a clinical benefit of intravenous magnesium sulfate infusion over placebo infusion in patients with acute aneurysmal subarachnoid hemorrhage OBJECT Despite the application of current st and ard therapies , vasospasm continues to result in death or major disability in patients treated for ruptured aneurysms . The authors investigated the effectiveness of continous MgSO4 infusion for vasospasm prophylaxis . METHODS Seventy-six adults ( mean age 54.6 years ; 71 % women ; 92 % Caucasian ) were included in this comparative matched-cohort study of patients with aneurysmal subarachnoid hemorrhage on the basis of computed tomography ( CT ) findings . Thirty-eight patients who received continuous MgSO4 infusion were matched for age , race , sex , treatment option , Fisher grade , and Hunt and Hess grade to 38 historical control individuals who did not receive MgSO4infusion . Twelve grams of MgSO4 in 500 ml normal saline was given intravenously daily for 12 days if the patient presented within 48 hours of aneurysm rupture . Vasospasm was diagnosed on the basis of digital substraction angiography , CT angiography , and transcranial Doppler ultrasonography , and evidence of neurological deterioration . Symptomatic vasospasm was present at a significantly lower frequency in patients who received MgSO4 infusion ( 18 % ) compared with patients who did not receive MgSO4 ( 42 % ) ( p = 0.025 ) . There was no significant difference in mortality rate at discharge ( p = 0.328 ) . A trend toward improved outcome as measured by the modifed Rankin Scale ( p = 0.084 ) , but not the Glasgow Outcome Scale ( p = 1.0 ) , was seen in the MgSO4 treated group . CONCLUSIONS Analysis of the results suggests that MgSO4 infusion may have a role in cerebral vasospasm prophylaxis if therapy is initiated within 48 hours of aneurysm rupture Objective : To examine whether the maintenance of elevated magnesium serum concentrations by intravenous administration of magnesium sulfate can reduce the occurrence of cerebral ischemic events after aneurysmal subarachnoid hemorrhage . Design : Prospect i ve , r and omized , placebo-controlled study . Setting : Neurosurgical intensive care unit of a University hospital . Interventions : One hundred ten patients were r and omized to receive intravenous magnesium sulfate or to serve as  controls . Magnesium treatment was started with a bolus of 16 mmol , followed by continuous infusion of 8 mmol/hr . Serum concentrations were measured every 8 hrs , and infusion rates were adjusted to maintain target levels of 2.0–2.5 mmol/L. Intravenous administration was continued for 10 days or until signs of vasospasm had resolved . Thereafter , magnesium was administered orally and tapered over 12 days . Measurements and Main Results : Delayed ischemic infa rct ion ( primary end point ) was assessed by analyzing serial computed tomography scans . Transcranial Doppler sonography and digital subtraction angiography were used to detect vasospasm . Delayed ischemic neurologic deficit was determined by continuous detailed neurologic examinations ; clinical outcome after 6 months was assessed using the Glasgow outcome scale . Good outcome was defined as Glasgow outcome scale score 4 and 5 . The incidence of delayed ischemic infa rct ion was significantly lower in magnesium-treated patients ( 22 % vs. 51 % ; p = .002 ) ; 34 of 54 magnesium patients and 27 of 53 control patients reached good outcome ( p = .209 ) . Delayed ischemic neurologic deficit was nonsignificantly reduced ( 9 of 54 vs. 15 of 53 patients ; p = .149 ) and transcranial Doppler-detected/angiographic vasospasm was significantly reduced in the magnesium group ( 36 of 54 vs. 45 of 53 patients ; p = .028 ) . Fewer patients with signs of vasospasm had delayed cerebral infa rct ion . Conclusion : These data indicate that high-dose intravenous magnesium can reduce cerebral ischemic events after aneurysmal subarachnoid hemorrhage by attenuating vasospasm and increasing the ischemic tolerance during critical hypoperfusion We performed a r and omized , double-blind , pilot study on magnesium sulfate ( MgSO4 ) infusion for aneurysmal subarachnoid hemorrhage ( SAH ) . Sixty patients with SAH were r and omly allocated to receive either MgSO4 80 mmol/day or saline infusion for 14 days . Patients also received intravenous nimodipine . Episodes of vasospasm were treated with hypertensive and hypervolemic therapy . Neurologic status was assessed 6 months after hemorrhage using the Barthel index and Glasgow Outcome Scale . Incidences of cardiac and pulmonary complications were also recorded . Patient characteristics , severity of SAH , and surgical treatment did not differ between groups . The incidence of symptomatic vasospasm decreased from 43 % in the saline group to 23 % in patients receiving MgSO4 infusion , but it did not reach statistical significance , P=0.06 . For patients who had transcranial Doppler-detected vasospasm , defined as mean flow velocity > 120 cm/s and a Lindegaard index > 3 , the duration was shorter in the magnesium group compared with controls ( P<0.01 ) . There was , however , no difference between groups in functional recovery or Glasgow Outcome Scale score . The incidence of adverse events such as brain swelling , hydrocephalus , and nosocomial infection was also similar in patients receiving MgSO4 or saline . In this small pilot study , MgSO4 infusion for aneurysmal SAH is feasible . On the basis of the preliminary data , a larger study recruiting approximately 800 patients is required to test for a possible neuroprotective effect of magnesium after SAH Summary Background Magnesium sulphate is a neuroprotective agent that might improve outcome after aneurysmal subarachnoid haemorrhage by reducing the occurrence or improving the outcome of delayed cerebral ischaemia . We did a trial to test whether magnesium therapy improves outcome after aneurysmal subarachnoid haemorrhage . Methods We did this phase 3 r and omised , placebo-controlled trial in eight centres in Europe and South America . We r and omly assigned ( with computer-generated r and om numbers , with permuted blocks of four , stratified by centre ) patients aged 18 years or older with an aneurysmal pattern of subarachnoid haemorrhage on brain imaging who were admitted to hospital within 4 days of haemorrhage , to receive intravenous magnesium sulphate , 64 mmol/day , or placebo .  We excluded patients with renal failure or bodyweight lower than 50 kg . Patients , treating physicians , and investigators assessing outcomes and analysing data were masked to the allocation . The primary outcome was poor outcome —defined as a score of 4–5 on the modified Rankin Scale—3 months after subarachnoid haemorrhage , or death . We analysed results by intention to treat . We also up date d a previous meta- analysis of trials of magnesium treatment for aneurysmal subarachnoid haemorrhage . This study is registered with controlled-trials.com ( IS RCT N 68742385 ) and the EU Clinical Trials Register ( EudraCT 2006 - 003523 - 36 ) . Findings 1204 patients were enrolled , one of whom had his treatment allocation lost . 606 patients were assigned to the magnesium group ( two lost to follow-up ) , 597 to the placebo ( one lost to follow-up ) . 158 patients ( 26·2 % ) had poor outcome in the magnesium group compared with 151 ( 25·3 % ) in the placebo group ( risk ratio [ RR ] 1·03 , 95 % CI 0·85–1·25 ) . Our up date d meta- analysis of seven r and omised trials involving 2047 patients shows that magnesium is not superior to placebo for reduction of poor outcome after aneurysmal subarachnoid haemorrhage ( RR 0·96 , 95 % CI 0·86–1·08 ) . Interpretation Intravenous magnesium sulphate does not improve clinical outcome after aneurysmal subarachnoid haemorrhage , therefore routine administration of magnesium can not be recommended . Funding Netherl and s Heart Foundation , UK Medical Research Council Background : There is limited information about the long-term consequences of subarachnoid hemorrhage ( SAH ) . Methods : Data were obtained from a population -based study of aneurysmal SAH conducted in Australia and New Zeal and between 1995 and 1998 . The authors report health outcomes for survivors 1 year after the onset of SAH . Results : From a total of 432 first-ever cases of SAH ( 76 % due to confirmed cerebral aneurysm rupture ) registered in four cities in Australia and New Zeal and , 242 ( 56 % ) were alive approximately 1 year later ( mean time 1.2 years ) , with 230 ( 95 % ) available for interview . Of those interviewed , 105 ( 46 % ) reported an incomplete recovery , with ongoing problems with memory ( 50 % ) , mood ( 39 % ) , speech ( 14 % ) , and self-care ( 10 % ) . Compared with age- and sex-adjusted Australian population norms , health-related quality of life , as determined by Short Form–36 , was significantly lower for cases in the domains of role limitations that result from physical problems . However , there were no patient or disease characteristics that predicted complete recovery from SAH . Conclusions : A high proportion 
    Output:
    
We identified a benefit in the role of magnesium to reduce the incidence of cerebral vasospasm in patients with an aneurysmal SAH .
However no benefit was found regarding improved favourable functional outcome or a reduction of mortality