Hypomagnesemia in Intracerebral Hemorrhage

Abstract

Background: Magnesium (Mg) is an essential element for the body's normal physiological functioning. It has a major role in modulating vascular smooth muscle tone and peripheral arterial resistance. A low serum Mg level on admission (HMg0) has been associated with more severe presentation in patients with subarachnoid hemorrhage. However, data on HMg0 specifically in relation to intracerebral hemorrhage (ICH) are scarce. We sought to determine the incidence and clinical significance of HMg0 in patients with ICH.

Methods: We reviewed the records of consecutive patients with ICH over a 2-year period. Data collected included initial Mg levels (Mg0), clinical and radiologic characteristics on presentation, and discharge outcomes. Regression analysis was performed to look for any association of low Mg0 with admission blood pressure (BP) and Glasgow Coma Scale (GCS) scores. We also examined the correlation of HMg0 with clinical/radiologic features, admission severity (based on the ICH score), and poor outcome on discharge.

Results: In all, 33.6% presented with HMg0. Mg0 levels were negatively associated with systolic BP presentation (P < 0.0001) and positively associated with the initial GCS scores (P = 0.01). Multivariate logistic regression showed an association between HMg0 and severity at presentation (P = 0.03), but not with poor outcome on discharge (P = 0.26).

Conclusions: HMg0 occurs in one third of patients with ICH and is associated with more severe presentation and intraventricular hemorrhage. Mg levels on admission correlate inversely with systolic BP and directly with GCS scores at presentation. HMg0 does not influence outcomes at discharge.

Keywords: Blood pressure; Hypomagnesemia; Intracerebral hemorrhage; Magnesium; Outcomes; Severity.