Tests suggest setback for Bret Michaels

(News Terupdate) - Medical tests show Bret Michaels has suffered a setback in his recovery from a brain hemorrhage, according to a statement posted on his official website Tuesday.

Despite the development, "doctors remain hopeful for a full recovery," the statement said.

The rock singer and reality TV star suffered a massive brain hemorrhage and was hospitalized Friday.

"Doctors state Michaels is very lucky as his condition could have been fatal," it said.

"Test results indicate a setback in Bret Michaels' condition, a side effect from the brain hemorrhage called hyponatremia, a lack of sodium in the body which leads to seizures," said the statement posted by road manager Janna Elias.

Michaels "is responding well to tests and treatments," she said.

"Even though today was a minor setback Doctors remain hopeful for a full recovery and plan to release more specific information next Monday."

Michaels, 47, was the lead singer for the '80s glam-metal "hair band" Poison. He became a reality star on the VH1 show "Rock of Love with Bret Michaels." He has also appeared on "Celebrity Apprentice."

His manager and publicist have been careful not to disclose the hospital or even the city where the singer is being treated. They cite security reasons for the secrecy.

Tuesday's statement offers the greatest detail so far about Michaels' condition and treatment.

"Michaels' medical workup demonstrated findings of a subarachnoid hemorrhage, a type of stroke that causes bleeding in the fluid-filled spaces around the base of the brain," the statement said. "It presents itself suddenly as the sound of a loud gunshot or thunderclap at the back of the head causing severe cranial pain and muscle spasms."

Michaels, who is in critical condition in an intensive care unit, has undergone a continuous series of tests "including angiograms, CT scans, MRIs and transcranial dopplers (TCDs)," the statement said. "With further testing and rehabilitation, they are hopeful that Bret will gradually improve as the blood surrounding the brain dissolves and is reabsorbed into his system, which can be a very painful recovery and take several weeks to months," it said.

The latest statement also addressed possible causes of Michaels' brain hemorrhage.

"Many people are speculating Michaels' head injury suffered from a prop striking the singer at the Tony awards last June is the cause," it said. "Additional studies are planned throughout the week to hopefully detect the exact cause of the rupture."

Michaels, who is a lifelong Type 1 diabetic, had an emergency appendectomy just 11 days before falling ill last week.

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Michaels' type of hemorrhage has wide range of outcomes

(News Terupdate) - The feeling of blood hitting the brain's sensitive covering can give a person the worst headache of his life, doctors say.

That's what happens in a subarachnoid hemorrhage, and that's what singer and reality star Bret Michaels, 47, might have felt before he was taken to the emergency room Thursday. A source close to the situation said Michael described it as "like [getting] hit in the head with a baseball bat over and over again," according to People magazine.

In a subarachnoid hemorrhage, an individual bleeds into the space between the brain and its transparent, web-like tissue covering. This is also the place where spinal fluid is located.

Doctors are still searching for the cause of Michaels' hemorrhage, his road manager posted on his website Monday.

"As of now, Bret remains in ICU under 24 hour surveillance," she wrote. "Further testing this week will help locate the source of the bleeding."

About 65,000 of these hemorrhages occur in the United States every year, said Dr. M. Sean Grady, chairman of neurosurgery at the Hospital of the University of Pennsylvania. Grady was not involved with treating Michaels.

Michaels' type of hemorrhage has a wide range of outcomes: Some patients die almost instantly, some will have difficulty speaking and other neurological dysfunction and some will walk away without long-term complications.

"Sometimes the patients will experience the onset of [the] absolute worst headache of their life, and can be wide awake and alert," said Dr. Daniel Barrow, chief of neurosurgery service at Emory University Hospital, who did not treat the singer. These are often called thunderclap headaches.

In about 10 to 15 percent of cases, the cause is never found. This scenario often has the most promising survival outcome, as these patients often make good recoveries and don't tend to have a recurrence, Barrow said.

The most common cause is physical injury, Barrow said. Car crashes can lead to a subarachnoid hemorrhage in young people, according to the National Institutes of Health. In the elderly, people who fall and hit their head may experience this kind of bleeding.

For spontaneous subarachnoid hemorrhages, an aneurysm is the likely cause, experts say. An aneurysm is a bulging of a blood vessel in the brain. About half of patients with a ruptured aneurysm die from the burst itself, Grady said.

Patients with hemorrhages undergo a procedure called an angiogram, a test used to visualize blood vessels. Sometimes the initial angiogram does not pick up an aneurysm because when the bleeding stops, the clotting fills the aneurysm. That is one possibility for Michaels' case, Barrow said, but he could also fall into the category of unknown cause.

Blood thinners and blood disorders can cause this type of bleed, Barrow said, as can cocaine.

Michaels had undergone an emergency appendectomy on April 12, less than two weeks before suffering the hemorrhage Thursday. The events are likely unrelated, Grady and Barrow said.

The singer's type I diabetes also does not put him at any greater risk of a subarachnoid hemorrhage, Grady said.

The brain's covering is pain-sensitive, and blood coming into contact with it hurts, resulting in a severe headache, Barrow said.

Other symptoms may include sudden loss of consciousness or diminished consciousness, nausea and vomiting, seizure, stiff neck, vision problems and mood changes, according to the National Institutes of Health.

If there is one, it's important to identify the aneurysm and treat it because it will bleed again, Barrow said. One treatment is to surgically clip the aneurysm, excluding it from the normal circulation. An alternative is to put tiny coils of soft platinum metal in the aneurysm.

Someone in Michaels' position would most likely have his blood pressure and neurological function monitored carefully, Grady said. Doctors would watch the arterial blood flow into the brain to make sure the vessels are working as they should, he said.

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Source: Bret Michaels was in excruciating pain

(News Terupdate) - As Bret Michaels continues to be watched closely by his doctors, a source reveals the rocker's excruciating moments before he was taken to the emergency room.

According to the source, Michaels, 47, said the headache that prompted him to call for an ambulance felt "like [getting] hit in the head with a baseball bat over and over again."

Often referred to by doctors as a "thunderclap headache" because of the intensity and suddenness of the pain, such headaches are a tell-tale symptom of the kind of brain hemorrhage that Michaels suffered.

The source close to the situation adds, "Bret is still in ICU. He still has the headache and is heavily sedated."

A statement on his fan site noted that doctors are still searching for the source of the bleeding.

"In some patients, doctors never find the source," says Dr. Keith Siller of New York University's Comprehensive Stroke Care Center. The bleeding could be very small, or the rupture itself can "cure" the source of the problem, says Dr. Siller.

If no source of an aneurysm or an abnormal vein-artery connection known as an AVM is found, "you basically just wait for the symptoms to go away," says Dr. Siller. The patient typically remains under close observation, as Michaels is, so doctors can monitor for possible complications.

But if the patient is able to speak, "they're on the better end of things," says Dr. Siller, noting that physical therapy and speech therapy are often required to make a full recovery.

On TV's "Celebrity Apprentice," on which Michaels is a participant, Sunday night's episode carried a post-script.

Accompanying slow-motion footage of Bret carrying luggage across a tarmac, a voiceover said, "Everyone here at NBC wishes Bret Michaels a speedy recovery."

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