NY TIMES
Secretary of State Hillary Rodham Clinton’s blood clot formed in her head, her doctors said on Monday, a potentially serious condition from which they nonetheless stressed they expect her to fully recover. Mrs. Clinton was hospitalized Sunday at NewYork-Presbyterian Hospital for the blood clot — in a vein between the brain and the skull and behind her right ear — and doctors said on Monday that it had not resulted in a stroke or neurological damage. They said they were treating her with blood thinners to try to dissolve the clot.
Dr. David Langer, a brain surgeon and an associate professor at the North Shore-Hofstra-Long Island Jewish School of Medicine, said that if this type of clot was untreated, it could cause blood to back up, and could lead to a hemorrhage inside the brain.
Mrs. Clinton’s doctors struck an upbeat tone in their statement. “In all other aspects of her recovery, the secretary is making excellent progress, and we are confident she will make a full recovery,” the statement said. “She is in good spirits, engaging with her doctors, her family and her staff."
The sudden turn in Mrs. Clinton’s condition appeared to take members of her staff by surprise. As recently as Sunday afternoon, they thought she was on the mend and ready to return to work this week.
Instantly, the woman who, before even announcing, has been widely viewed as a front-runner for the Democratic presidential nomination in 2016, someone who has spent the past four years keeping up a grueling schedule in which she racked up miles as the most-traveled secretary of state and visited 112 countries, was seeming uncharacteristically fragile.
Instead of talking about who might be her running mate, or how she had, even on Monday, again been named the most admired woman in America in a Gallup poll, the chatter on the Potomac shifted to talk about how, at the end of the day, she is a 65-year-old woman trying to recover after falling and hitting her head.
Mrs. Clinton’s friends say they have become increasingly concerned about her since she fell ill in mid-December from a stomach virus that left her severely dehydrated. She was vomiting constantly, friends said, and fell forward, hitting her head and blacking out. The result, one friend said, was a contusion on her eye and on her brain.
Dr. Geoff Manley, vice chairman of neurological surgery at the University of California, San Francisco, said patients with this condition generally needed to be treated in an intensive care unit, by specialists with expertise in this kind of clot.
The treatment usually begins with intravenous blood thinning drugs, and scans to monitor the clot. After a few days, patients can usually be moved to a regular hospital floor and be gradually switched from intravenous drugs to pills. Barring complications, after a few more days they can usually go home. But the clot may take weeks or months to dissolve, and treatment will continue for even longer to prevent a recurrence.
This type of venous clot is more common in women than in men, Dr. Langer said, particularly with dehydration. But it is impossible to say exactly what caused it in Mrs. Clinton’s case — her head injury, the illness, some other factor or a combination.
Given that she has had a blood clot in the past — in her leg in 1998 — she may be prone to form clots, and may need lifelong treatment to prevent them, possibly with low doses of aspirin or other blood-thinning drugs.