Bret Michaels hospitalized AGAIN w/ Brain Hemorrhage

General
1

http://voices.washingtonpost.com/celebritology/2010/04/bret_michaels_hospitalized_wit.html

 

Apparently Bret is in the hospital again just a few days after surgery to remove his appendix.  I wonder if it has anything to do with diabetes or the surgery? 

2

i'm pretty sure a brain hemmorhage is separate from diabetes or appendix surgery. he has something else going on - bleeding in your brain isn't common... or good.

3

I agree - brain clots could be d-related, but I've never heard of hemorrhages being d-related.

4

Causes

In 85% of cases of spontaneous SAH, the cause is rupture of a cerebral aneurysm—a weakness in the wall of one of the arteries in the brain that becomes enlarged. They tend to be located in the circle of Willis and its branches. While most cases of SAH are due to bleeding from small aneurysms, larger aneurysms (which are less common) are more likely to rupture.[1]

In 15–20% of cases of spontaneous SAH, no aneurysm is detected on the first angiogram.[14] About half of these are attributed to non-aneurysmal perimesencephalic hemorrhage, in which the blood is limited to the subarachnoid spaces around the midbrain (i.e. mesencephalon). In these, the origin of the blood is uncertain.[1] The remainder are due to other disorders affecting the blood vessels (such as arteriovenous malformations), disorders of the blood vessels in the spinal cord, and bleeding into various tumors.[1] Cocaine abuse and sickle cell anemia (usually in children) and, rarely, anticoagulant therapy, problems with blood clotting and pituitary apoplexy can also result in SAH.[6][14]

Subarachnoid blood can be detected on CT scanning in as many as 60% of people with traumatic brain injury.[15] Traumatic SAH (tSAH) usually occurs near the site of a skull fracture or intracerebral contusion.[14] It usually happens in the setting of other forms of traumatic brain injury and has been linked with a poorer prognosis. It is unclear, however, if this is a direct result of the SAH or whether the presence of subarachnoid blood is simply an indicator of severity of the head injury and the prognosis is determined by other associated mechanisms.

 

Classification

There are several grading scales available for SAH. The Glasgow Coma Scale is ubiquitously used for assessing consciousness. Three specialized scores are used to evaluate SAH; in each, a higher number is associated with a worse outcome.[16] These scales have been derived by retrospectively matching characteristics of patients with their outcomes.

The first scale of severity was described by Hunt and Hess in 1968:[17]

 


Grade Signs and symptoms Survival
1 Asymptomatic or minimal headache and slight neck stiffness 70%
2 Moderate to severe headache; neck stiffness; no neurologic deficit except cranial nerve palsy 60%
3 Drowsy; minimal neurologic deficit 50%
4 Stuporous; moderate to severe hemiparesis; possibly early decerebrate rigidity and vegetative disturbances 20%
5 Deep coma; decerebrate rigidity; moribund 10%

 
Just some info from Wikipedia.org
5

"Diabetes is a prominent risk factor for ischemic but not hemorrhagic stroke. It is responsible for 7% of deaths in stroke patients."

Taken from: 

http://www.eso-stroke.org/faq_04.php?cid=8

So this would tell me that diabetes is likely NOT a significant factor in a subarachnoid hemorrhage.

6

Sue -- Circle of Willis, Glasgow Coma Scale -- you're bringing back bad memories from grad school!