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Thursday, April 29, 2010

Bret Michaels’ Hyponatremia: What Does This Mean for Him?

After suffering from a subarachnoid hemorrhage (bleeding in the brain), Bret Michaels is now experiencing a common complication called hyponatremia.

Hyponatremia – low sodium levels in the blood – occurs when brain cells are damaged as happens with bleeding in the brain. It’s not clear why, but these patients release too much of a hormone called ADH. The condition is a bit of a mouthful – it’s called syndrome of inappropriate antidiuretic hormone secretion or SIADH.

If SIADH goes unnoticed or untreated, it can be life threatening. However, in most cases it’s treatable.

But treatment is particularly complicated in people with subarachnoid hemorrhage. In most people with SIADH, as strange as it sounds, we actually restrict the amount of fluids we give them. This slowly allows sodium levels to begin to rise.

However, in people with bleeding in the brain, restricting fluids can actually be dangerous. For these patients, we often have to give a solution called hypertonic saline, which is fluid with high amounts of sodium. This has to be done very carefully as raising sodium levels too quickly can lead to even further brain injury.

Bret Michaels’ doctors will likely get his SIADH under control. His prognosis is more dependent on the amount of brain injury that he suffered from the bleeding. This is just a speed bump along the road to recovery and Michaels’ prognosis will depend on many factors, such as how severe the bleeding was and how much brain damage he suffered.

We’ll be keeping an eye on his progress to watch for any further development or complications he may experience along the way.

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Posted by: Michael Smith, MD at 3:44 pm


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