Tuesday, January 1, 2013

Spin Machine Alert: Hillary's "concussion" story not vindicated by blood clot episode UPDATE: Maybe so

Jan 1, 2013

(Dr. Milton Wolf) - The Clinton spin machine is once again in high gear. They want you to believe that the blood clot that Hillary is currently suffering from is somehow related to a previous concussion.

Let me be clear: Head concussions do not cause leg or lung clots.

Team Clinton has reported that Hillary is suffering from "blood clots" and is being treated with anticoagulants. They are being purposefully vague about the site of those blood clots but they are almost certainly in her legs. Hillary has a history of clots in her leg veins known as deep venous thrombosis or DVT. These are usually easily treated with anticoagulants but can be deadly if they mobilize and travel to the lungs which is known as pulmonary embolism or PE.

Recall that NBC's David Bloom died from a pulmonary embolism in 2003 while embedded with U.S. troops during the invasion of Iraq when a DVT traveled from his leg to his lungs.


What does this have to do with a head concussion? Nothing. Head concussions don't cause leg vein clots.

Did you get that? Head concussions do NOT cause leg vein clots.

Look closely how Team Clinton operates: First, Philippe Reines, a deputy assistant secretary, said in the statement that the clot stems from a concussion Clinton sustained several weeks ago. No it didn't. Then apparatchiks in the mainstream media report that the concussion caused the blood clot. No it didn't. And left-wing hacks attack anyone who ever doubted the head concussion story.

I still doubt the head concussion story.

Hillary's concussion story is highly suspicious and conveniently allowed her to escape testifying about Benghazi (just like the stomach virus story that proceeded it). I still haven't seen the evidence that Hillary ever suffered a concussion.

Was she ever evaluated in an Emergency Department? Did she even go to the hospital? Did she undergo head CT scanning? This is standard of care for head trauma patients. As a radiologist, I see these every day. This is med school 101.

And there is no way on earth that a person -- any person, let alone the Secretary of State -- could be suffering the effects of head trauma for three weeks without undergoing something as simple and common as a CT head scan. Most Emergency Departments order dozens of these every day.

Until they show us the evidence, I will continue to doubt that Hillary ever suffered any serious head trauma.

And don't let MSM apparatchiks confuse you. Some are promulgating a theory that Hillary's blood clot is not in her legs but is instead located in her brain. They claim this caused or was the result of her fainting spell and head trauma. This is wrong. Head trauma can, of course, cause intracranial hemorrhage and even damage to the arteries supplying the brain but not leg vein clots. Furthermore, Hillary is being treated with anticoagulants (blood thinners). Every medical student knows you don't give anticoagulants to post-traumatic intracranial hemorrhage patients. They will bleed more and may die.

Let's hope that doctors can successfully treat Hillary's blood clot and, as Smitty from The Other McCain says: "May Secretary of State Clinton receive better treatment than Ambassador Stevens, Smith, Woods or Doherty."


UPDATE: Even NBC is starting to raise questions.

UPDATE 2: CNN is reporting that Hillary's blood clot is "located between brain and skull" specifically within the dural sinuses. These are specialized high-capacity veins for the brain (and have nothing to do with the nasal sinuses).

Sinus thrombosis (clotting of the blood in the dural sinuses) is thankfully a very rare abnormality. I've probably seen 5 or so in my career, including my training at a very busy neurosurgical hospital. It is distinguished from post-traumatic intracranial bleeding (typically subdural or epidural hematomas or subarachnoid hemorrhage). In this condition, blood clots are not in the brain itself but rather is confined within the dural sinuses.

Here is normal MRI venography imaging of a patient's dural sinuses:


Patients with sinus thrombosis commonly have headaches and are at a significant risk of stroke. These "venous infarcts" are also at risk of direct bleeding in the brain.

Sinus thrombosis is typically caused by blood clotting disorders but can be caused by trauma. Typically the trauma must be substantial and include a skull fracture that directly crosses one of the sinuses however there are exceedingly rare case reports of sinus thrombosis attributed at least to trivial trauma.

This may explain Hillary's condition however, considering that she's a known "clotter," it's possible that this thrombosis, as rare as it is, was still spontaneous. In either event, I trust her doctors will perform appropriate blood analysis to determine any possible need for long-term blood thinners. However most are treated similarly to leg vein clots, which are enormously more common, with temporary blood thinners.

If I was premature questioning the honesty of a Clinton, I apologize.

Hat tip: Im41.com

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