The blood clot between Secretary of State Hillary Clinton’s brain and skull is a rare and potentially dangerous condition, raising both concerns and questions for top specialists.
“I see only a few cases a year,” said Dr. Michael R. Jaff, medical director of Massachusetts General Hospital’s Institute for Heart, Vascular and Stroke Care. “It always raises a red flag when this happens. It’s just a weird place for this to happen.”
Clinton’s doctors said in a statement yesterday that an MRI scan “revealed that a right transverse sinus venous thrombosis had formed. This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear. It did not result in a stroke, or neurological damage. To help dissolve this clot, her medical team began treating the secretary with blood thinners. 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.”
Jaff, who is not involved in Clinton’s care, said that when he first heard about the clot he assumed it was a relatively run of the mill “subdural hematoma” resulting from her recent fall, which caused a concussion.
But his anxiety rose when her doctors described the clot, discovered on an MRI on Sunday, lodged near her brain.
“That’s far more concerning in my mind,” Jaff said. “I don’t think they expected it.
“This is a very unusual vein to form a clot,” Jaff said. “It’s unusual to occur from head trauma, especially minor head trauma of the kind you’d suffer with a concussion.” With football players who suffer serious head injuries, he said, few develop a clot like this.
Dr. James Holsapple, chief of neurosurgery at Boston Medical Center, said the rare condition suggests “she may be ill with something unknown or unannounced — and we’re seeing bits and pieces of the story.”
Holsapple said that absent a skull fracture, this kind of clot may be associated with the hormone disruptions of pregnancy, birth control pills, estrogen replacement therapy or cancer.
Jaff said Clinton’s history of forming at least one other clot offers a clue.
“That makes me think it’s something in her blood that makes her more likely to clot,” Jaff said. Unusual proteins in the blood may have that effect, he said. “David Bloom, the TV correspondent who died in the first Gulf War, had one of those proteins in his blood.”
Jaff said anti-coagulant drugs usually work. In a few cases where drugs are ineffective, stroke risk could force doctors to consider surgery or try to use a catheter to inject drugs directly into the clot.
“You have to try to get blood to flow through or bad things could happen,” Jaff said. “If she were to start to deteriorate, we’ll know sooner rather than later.”
Herald wire services contributed to this report.
“I see only a few cases a year,” said Dr. Michael R. Jaff, medical director of Massachusetts General Hospital’s Institute for Heart, Vascular and Stroke Care. “It always raises a red flag when this happens. It’s just a weird place for this to happen.”
Clinton’s doctors said in a statement yesterday that an MRI scan “revealed that a right transverse sinus venous thrombosis had formed. This is a clot in the vein that is situated in the space between the brain and the skull behind the right ear. It did not result in a stroke, or neurological damage. To help dissolve this clot, her medical team began treating the secretary with blood thinners. 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.”
Jaff, who is not involved in Clinton’s care, said that when he first heard about the clot he assumed it was a relatively run of the mill “subdural hematoma” resulting from her recent fall, which caused a concussion.
But his anxiety rose when her doctors described the clot, discovered on an MRI on Sunday, lodged near her brain.
“That’s far more concerning in my mind,” Jaff said. “I don’t think they expected it.
“This is a very unusual vein to form a clot,” Jaff said. “It’s unusual to occur from head trauma, especially minor head trauma of the kind you’d suffer with a concussion.” With football players who suffer serious head injuries, he said, few develop a clot like this.
Dr. James Holsapple, chief of neurosurgery at Boston Medical Center, said the rare condition suggests “she may be ill with something unknown or unannounced — and we’re seeing bits and pieces of the story.”
Holsapple said that absent a skull fracture, this kind of clot may be associated with the hormone disruptions of pregnancy, birth control pills, estrogen replacement therapy or cancer.
Jaff said Clinton’s history of forming at least one other clot offers a clue.
“That makes me think it’s something in her blood that makes her more likely to clot,” Jaff said. Unusual proteins in the blood may have that effect, he said. “David Bloom, the TV correspondent who died in the first Gulf War, had one of those proteins in his blood.”
Jaff said anti-coagulant drugs usually work. In a few cases where drugs are ineffective, stroke risk could force doctors to consider surgery or try to use a catheter to inject drugs directly into the clot.
“You have to try to get blood to flow through or bad things could happen,” Jaff said. “If she were to start to deteriorate, we’ll know sooner rather than later.”
Herald wire services contributed to this report.