Bret Michaels has experienced another medical complication, a condition known as hyponatremia, according to a statement posted Tuesday on the website of the 47-year-old reality TV star and former Poison frontman.
The condition, defined by abnormally low levels of salt in the blood can lead to seizures and brain swelling, and is the latest development in the health problems that have affected Michaels since his hospitalization last Friday for what his publicist confirmed was a massive subarachnoid hemorrhage, or bleeding at the base of his brain stem.
On Sunday, statements posted on the star's official website indicated that he was still in critical condition in the intensive care unit of an undisclosed hospital. The statements also indicated that doctors had not yet located the source of the bleeding in his brain.
Neurologists said it is overwhelmingly likely that the complication arose from Michaels' brain bleed.
"It is not at all unexpected that Mr. Michaels has hyponatremia," said Dr. Wendy Wright, an assistant professor of neurology and neurosurgery at Emory University Hospital in Atlanta, and a specialist in hyponatremia after brain injury. "There are several potential causes that tend to involve chemical imbalances in the brain, leading to either a slight increase in total body fluid -- making the relative amount of sodium in the body seem lower -- or a loss of sodium in the urine."
Dr. Vivek Deshmukh, director of cerebrovascular and endovascular neurosurgery at George Washington University in Washington, D.C., said hyponatremia is "very commonly seen" in subarachnoid hemorrhage patients, and the risk of the complication is in fact one of the reasons that doctors monitor these patients so closely in the intensive care unit.
Deshmukh also said it is unlikely that the condition will affect Michaels' prognosis, though the occurrence of such sodium fluctuations may prolong a patient's hospitalization.
"Hyponatremia that is detected early should not be associated with any long-term complications and the overall prognosis remains unchanged," he said. "Treatment is typically straightforward and requires simply replacing the sodium in the blood."
Wright said, however, that determining exactly how this new complication will factor in to Michaels' chances of a normal recovery are as yet unclear.
"We do not have much information at this time about Mr. Michaels' clinical condition to understand how significant a setback this is," she said. "Best case scenario, this would be something that was found pre-emptively, will be treated sufficiently and will not cause any further harm to Mr. Michaels."
If the condition had gone undetected, however, Michaels could have been at risk of such serious side effects as seizures, brain swelling and neurological decline. "Some of these side effects can be permanent," Deshmukh said.
Wright said swelling would pose the greatest threat. "Swelling of the brain would typically present as progressive loss of consciousness, or even coma," she said. "The treatment is to correct the hyponatremia, but even treating the sodium levels too rapidly can have complications."
Still, Tuesday's statement on Michaels' website said he was remaining positive and responding well to tests and treatments, and that he remained hospitalized and conscious in critical but stable condition.