A well-known male singer died of cerebral hemorrhage after singing on stage! Be careful when singing with such people

Earlier, the media reported that Atsushi Sakurai, the lead singer of the well-known Japanese visual band BUCK-TICK, felt unwell when he sang a high note at a concert and was rushed to the hospital for emergency treatment before being pronounced dead. Sakurai's agency later issued a statement confirming that he died of brain stem hemorrhage at the age of 57.

Can singing cause cerebral hemorrhage? According to reports, similar situations have occurred many times.

Why does singing cause cerebral hemorrhage?

Singing is a great pastime that can benefit your mind and body. Singing has been shown to exercise not only your brain but your body as well, improving breathing, posture and relieving muscle tension. Listening to and participating in music has been shown to effectively relieve pain and maintain health by boosting the immune system.

However, if you become extremely emotional while singing high notes, your breathing patterns may be incorrect, and muscles throughout your body may contract, causing a transient increase in blood pressure. This can easily create excessive pressure on the already weak aneurysm vessel wall, causing the existing aneurysm to rupture.

In June 2020, Ms. Zhang from Dalian, Liaoning, sang high notes in "Qinghai-Tibet Plateau" at a family gathering. She suddenly had a severe headache, nausea and vomiting. Her family rushed her to the hospital for treatment. After a full cerebral angiography, it was found that the aneurysm was ruptured. After a 2-hour interventional surgery, the ruptured aneurysm was properly treated.

Image source: Screenshot of Kankan News video

What is a brain aneurysm?

In order to deliver nutrients to every corner of the brain in a timely manner, the blood vessels in our brain are thin and dense, distributed throughout the brain like a spider web.

Under normal circumstances, the blood flow in the cerebral vessels is unimpeded as the heart beats. However, as people age and have irregular lifestyles, such as smoking, drinking, obesity, etc., some areas in the blood vessels that are susceptible to blood flow, such as bends and angles, gradually become thinner, and abnormal expansion or bulging occurs under pressure, protruding outside the blood vessels. This is called a cerebral aneurysm, or intracranial aneurysm.

The tumor-like protrusion is a brain aneurysm. Image source: Columbia University

How common are brain aneurysms? The overall incidence rate worldwide is 3.2%, which means that 3 out of every 100 people have brain aneurysms, while in China, 7 out of every 100 people over 35 have aneurysms.

Weak, damaged blood vessels, long-term high blood pressure affecting the blood vessel walls, and people with high stress and irregular lifestyles are prone to aneurysms. Most patients do not have any symptoms, and often require some special examinations to detect.

We can detect the presence of aneurysms by using CT or MRI angiography. The round area pointed by the arrow in the picture below, which is different from the surrounding blood vessels, is the aneurysm.

CTA suggests basilar artery tip aneurysm Source: WestJEM

Most aneurysms do not rupture, they will coexist with us honestly. Among people with aneurysms, the annual rupture rate is 1.2% , and after rupture, it will be subarachnoid hemorrhage, so most of the cerebral hemorrhage we often talk about is caused by aneurysm rupture.

In addition to singing high notes, aneurysm rupture can also be caused by straining during bowel movements or being extremely emotional.

What should I do if a brain aneurysm ruptures?

Once a cerebral aneurysm ruptures, the blood in the artery immediately enters the subarachnoid space. This blood will stimulate the brain tissue and blood vessels and nerves, causing obvious symptoms.

Patients often experience an explosive headache, accompanied by dizziness, nausea, and hemiplegia on one side of their hands and feet, which can make them unable to lift their hands, etc. They may even fall into a coma or become life-threatening. At this time, it is important to remember that you must seek medical attention in a timely manner and do not delay the condition.

Ruptured cerebral aneurysms can be treated by both surgery and intervention. In surgical treatment, a small clamp (as shown in the left picture below) is inserted through a tiny incision to clamp the aneurysm completely to stop further bleeding, so the effect is immediate.

Intravascular interventional treatment is a procedure where doctors insert a long microcatheter through the blood vessels directly to the site of the ruptured aneurysm. Then, through this hollow microcatheter, soft spring coils that can change direction according to the shape of the aneurysm are continuously inserted. When the coils are delivered to a certain density, these densely stacked spring coils can block the blood flow, thereby preventing bleeding and treating the aneurysm (as shown in the right picture below).

Treatment of cerebral artery rupture Source: ICD10monitor

For patients who receive timely surgical treatment and complete clipping, the probability of recurrence after surgery is less than 1% , and drug treatment can be chosen according to the situation in the later stage. However, regular follow-up is required, and attention should be paid to regular living and diet, and regular exercise should be carried out to change the internal environment and prevent aneurysms in other parts from recurring.

Brain aneurysm is an SOS signal given to us by the brain blood vessels. If it is treated in time, we can still have a good quality of life. However, if we ignore this body signal, it will bring us unbearable consequences.

Health Tips

Singing is good, but be careful with the high notes;

Don't panic if you find anything abnormal; seek timely treatment to ensure safety.

Planning and production

Source: Shanghai Science and Technology Museum

Author: Song Jianping, deputy chief physician of neurosurgery, Huashan Hospital, Fudan University

Reviewer: Tang Qin, Director and Researcher of the Science Popularization Department of the Chinese Medical Association

Editor: Wang Mengru