Clinton's blood clot could have had dire consequences: Physician skill or luck?

Kathleen Blanchard's picture
Hilary Clinton's blood clot could have been fatal, say sources.
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Secretary of State Hilary Clinton is reportedly doing well following a serendipitous discovery of a blood clot located in her brain. According to multiple reports, the clot was located in an area that could have led to dire consequences, including stroke or hemorrhage. Some experts say she’s just lucky.

ABC News reports Clinton is recovering well and is receiving blood thinners. But she ‘dodged a bullet’ because the complication is for one, rare in the absence of a skull fracture. Secondly, the type of clot, known as a cerebral venous thrombosis, can be life-threatening and even fatal.

Dr. Brian D. Greenwald, medical director at JFK Johnson Rehabilitation Center for Head Injuries told ABC news "It could have potentially serious complications." He says it’s ‘lucky’ that her medical team decided to perform and MRI that found the complication.

The vein where the clot was located drains the brain. When flow of blood and brain fluids becomes obstructed it can cause blood cells to die from lack of oxygen and nutrients (ischemic stroke). Another possibility is that a blood vessel will burst, causing a hemorrhagic stroke from the increased pressure.

Greenwald said the only time he’s ever seen the condition develop is in the presence of dehydration because the blood is thicker. The event following a concussion can be seen in conjunction with a virus, which Clinton suffered from in early December, leading to her fall.

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The occurrence of cerebral venous thrombosis (CVT) was also reported in a 40 year old man by the Departments of Pediatric Neurology, Cleveland Clinic Foundation Ohio who suffered a minor injury from a ‘poor golf swing’.

The man had no known risks for CVT prior to the minor injury. A concurrent review of literature led the authors to conclude that even a minor head injury can lead to the same type of blood clot found by Clinton’s team; under ‘certain circumstances”.

The 40 year old was found to have anticardiolipin antibodies that the authors believe contributed to the clot and are found in patients with lupus. The man did not have lupus however.

Experts agree that Mrs. Clinton could have a clotting disorder that predisposed her to unusual complication. She reportedly had a blood clot in her leg in 1998. Clinton’s concussion complication could have been fatal.

One of the questions posed by physicians commenting on her case is if a regular patient would have received the same treatment. Whether the optimal treatment she's received is the result of luck, skillful physicians or other factors that have yet to be made public are interesting questions. We’re just glad she’s doing well.

Resource:
PubMed.gov
"Traumatic intracerebral venous thrombosis associated with an abnormal golf swing."

Image credit: Wikimedia commons

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