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Hillary's 'clot' is subdural hematoma
 | Followup, though the URL is the same as yesterday's story. I really dislike how the NYT does that. |
WASHINGTON -- Doctors treating Secretary of State Hillary Rodham Clinton on Monday said that she suffered a blood clot in a vein between her brain and skull behind her right ear but predicted that she would make a full recovery.
Mrs. Clinton was hospitalized on Sunday with a blood clot stemming from a concussion she suffered earlier this month, a State Department spokesman said.
Her doctors said in a statement on Monday that the clot did not result in a stroke or neurological damage and that she was being treated with blood thinners. In a statement, Drs. Lisa Bardack and Gigi El-Bayoumi, who are treating Mrs. Clinton, said: "She will be released once the medication dose has been established. In all other aspects of her recovery, the secretary is making excellent progress and we are confident she will make a full recovery. She is in good spirits, engaging with her doctors, her family, and her staff."
| I don't like treating a subdural with anticoagulants. Too much can go wrong. |
Mrs. Clinton, who had canceled most of her public events in recent weeks because of the injury, was at a follow-up examination on Sunday when doctors discovered the blood clot, according to Philippe Reines, her longtime spokesman.
Aides said that Mrs. Clinton, 65, had become dehydrated this month because of a stomach virus she contracted during a trip to Europe. She fainted and struck her head, causing the concussion. State Department officials had said that Mrs. Clinton fainted when she was at home alone in Washington but added that the concussion was not diagnosed immediately.
She canceled a planned trip to Morocco, and Victoria Nuland, a State Department spokeswoman, gave a mixed picture about the severity of her illness, describing her as having a "very uncomfortable stomach virus" and then saying she was "under the weather."
| Concussion symptoms and subdural symptoms are often the same/similar, and distinguishing between the two isn't easy. With the history of the fall, however, you'd thought she would have had either an infused CT or an MRI immediately, and a 2nd scan 48 hours later. |
An expert not involved in Mrs. Clinton's care said that clots are most common in the leg
| That would be a deep vein thrombosis. |
or in a large vein in the head.
| That would be a cavernous sinus thrombosis; those are downright dangerous. |
Dr. David Langer, a brain surgeon and associate professor at Hofstra-North Shore-Long Island Jewish School of Medicine, said that prompt treatment usually dissolves the clots, but that untreated clots in the head can become more worrisome and even lead to a hemorrhage inside the brain. Blood-thinning drugs can dissolve the clots, he said, and patients may need to stay on them for weeks or months to make sure the problem does not recur.
| The alternative is surgery to remove the clot: that can be a real problem, of course, but long-term anticoagulation for a subdural also has real risks. |
| Let us hope she heals well and quickly, so that she can enjoy her retirement. |
Posted by: Steve White 2013-01-02 |
