Unless you've yet to come out of your winter hibernation, you've likely heard about the subarachnoid hemorrhage (SAH) suffered-just days after an emergency appendectomy-by Poison front man and "The Celebrity Apprentice" contestant Bret Michaels. But few media sources have gone past reporting the incident to explain how it could affect Michaels long-term (should he survive) and how it might have been prevented; Matt Mealiffe, MD, over at DNA and You, is an exception.
Unless you’ve yet to come out of your winter hibernation, you’ve likely heard about the subarachnoid hemorrhage (SAH) suffered—just days after an emergency appendectomy—by Poison front man and “The Celebrity Apprentice” contestant Bret Michaels, who was rushed to the hospital on April 22 after complaining of a severe headache. But few media sources have gone past reporting the incident to explain how it could affect Michaels long-term (should he survive) and how it might have been prevented; Matt Mealiffe, MD, over at DNA and You, is an exception.
After explaining the statistics surrounding SAH—affects roughly 30,000 people yearly in the US, accounts for one in 20 to one in 50 new strokes, about one-half result in death, nearly 50% of survivors experience long-term cognitive impairment, and a significant number require lifelong care—Mealiffe reviews the several major know risk factors for SAH that are potentially modifiable:
• Cigarette smoking
• High blood pressure
• Cocaine use
• Heavy alcohol use
While one could make their assumptions about Bret Michaels having had issues with any of the above, as a lead singer for an ‘80s rock band, they’re only assumptions and we at MDNG were hard-pressed to find any confessions by Michaels (other than scattered quotes that he does drink and party some). So, maybe lifestyle didn’t play a role in his hemorrhage.
Mealiffe points out that risk is clearly elevated, at about a two- to six-fold increase, in first-degree relatives of people who have had an SAH. “In some cases this is due to rare Mendelian conditions that are associated with a significantly elevated risk; however, there is also evidence supporting a heritable genetic influence on intracranial aneurysms and SAH that occurs outside of the context of rare syndromes,” he writes. “In this case, risk is complex and associated with weaker genetic influences and environmental risk factors.”
So, what can physicians gain from this tragic event? Remember to tell those who have experienced an SAH and their family members to quit smoking or never smoke, control their blood pressure, avoid heavy drinking, and stay away from cocaine.