Neurologist Explains What A Blood Clot In Hillary Clinton's Brain Means

hillary clintonRichard C. Senelick, MD, is a neurologist who serves as medical director of the Rehabilitation Institute of San Antonio. He is also editor in chief of HealthSouth Press.

We see it all the time. Someone takes a blow to the head that stuns them for a moment. They don't lose consciousness. They don't even "see stars" or forget where they are. They might fall at home, on the ski slopes, or while trying to show their grandchildren that they remember how to roller skate. Maybe they have a nagging headache and some dizziness that just won't go away.

Then, about 2-3 weeks later, their family notices some subtle changes in their memory and personality, or their headaches suddenly worsen. Their doctor sends them for a CT scan of their brain, and their jaws drop open when they hear her say, "You have a blood clot pressing down on the top your brain. We call it a subdural hematoma." The doctor goes on to say, "You may need an operation on your brain." 

This is what some were speculating was the problem that resulted in Secretary Clinton's hospitalization yesterday, as it a State Department press release said it was related to a fall with head trauma earlier in the month. What didn't make sense with that were the reports that her doctors were giving her "blood thinners" to treat her problem. We would never do that to someone with a blood clot around their brain -- unless it was not a subdural hematoma at all, but a clot within a blood vessel. The most recent reports of "venous sinus thrombosis" mean just that. It makes sense to physicians, but what does it mean, and how can something that sounds so serious as a blood clot in the brain have such a positive prognosis?

Blood Clots and the Brain

A stroke that is caused by a blood clot inside the brain is usually a hemorrhage from a broken blood vessel. A blood clot on top of the brain after trauma is a subdural or epidural hematoma and usually requires surgery to remove the blood clot. These are very dangerous -- Natasha Richardson, Liam Neeson's wife, died from an epidural hematoma after a mild head injury skiing in Canada. But, Secretary Clinton's venous sinus thrombosis is very rare and quite uncommon after a mild head injury. 

Blood is carried from the heart to the brain under high pressure in four main arteries. Just like elsewhere in the body, the blood returns to the heart through a series of low pressure veins. What is different in the brain, is that there are a number of small lakes or "sinuses" where are similar to rivers feeding a lake, the small veins returning the blood. One of these, called the transverse sinus, is located behind the ear (where press releases have said her clot was), inside the skull and is vulnerable to trauma. Under normal conditions the blood would slowly flow through the sinus, but it can clot (thrombosis) for a number of reasons, including pregnancy, cancer, infection, head injury, and certain medications.

What Are the Symptoms?

It can be very difficult to diagnose a venous thrombosis, and it may that Secretary Clinton's problem was identified on either a routine follow-up brain scan or she had an increase in her symptoms after her concussion. Symptoms may include headaches or temporary disturbances in cognition or confusion, weakness or speech problems, or seizures. There are no reports of any such symptoms in Clinton's case.

How Do You Treat It?

It is best to try and dissolve the clot or at least to keep it from increasing in size. This is done by using the same medicines that we use to treat blood clots in the veins in the legs, thrombophlebitis. Depending on the individual patient and her doctor, they may choose different ways to "thin" the blood or keep it from clotting. The most common is to administer heparin into a vein the arm by an intravenous drip. The degree of blood thinning or anticoagulation can be carefully monitored by regular blood tests. Once everything is stable, an oral medication, warfarin, is started and eventually the IV drip of heparin can be discontinued. Although it may vary, most patients will remain on an oral anticoagulant for 3-6 months.

Hopefully the treatment will be successful, the blood clot dissolved and complications averted. As we enter the New Year we wish Secretary Clinton a speedy and full recovery.

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Maple Syrup Heist Could Make Your Pancake Breakfast More Expensive

Maple syrup heistIf you're relaxing at home enjoying a plate of flapjacks this New Year's morning, savor it while you can. The brazen theft, over the course of a year, of millions of gallons of maple syrup from Canada's strategic syrup reserve (yes, there apparently is such a thing), could spell higher prices for the "liquid gold" in 2013.

The mystery began back in August, when the Federation of Quebec Maple Syrup Producers was checking inventory at its St.-Louis-de-Blandford warehouse, a key depot in the strategic reserve and home to some 3.4 million barreled liters of the sweetener.

But instead of the expected unadulterated reservoir of syrupy goodness, the inspection revealed barrel after barrel to be empty.

Apparently, a gang of sweet-toothed thieves had rented warehouse space adjacent to the syrup depot and worked their way into the locked and guarded space to siphon its sugary contents. In all, authorities estimate that some 16,000 45-gallon barrels of syrup were drained from the depot over a period of nearly a year. The long-running heist yielded an estimated $20 million to $30 million worth of syrup.

Rounding up the ring

The good news: Last week, the Canadian Mounties got their man. Their men, actually.
So far, 18 members of a syrup "trafficking" ring have been arrested in connection with the theft. A further seven suspects are still at large, and perhaps -- we're seriously not making this up -- vacationing in Florida for the winter.

Police say they've tracked down two-thirds of the stolen syrup, which had been shifted across the provincial border to New Brunswick in tanker trucks. That still leaves one-third of the heist unaccounted for -- well over 200,000 gallons of pure maple treasure, equal to roughly 2 percent of annual maple syrup production globally.

Authorities believe that during the year-long heist a lot of the stolen syrup was sold onto the world market. Poetically put, the thieves have probably flooded the market with "hot" syrup. Even if it has been ladled out in drips and drabs, the addition of more than 2 percent of global syrup production to the supply chain has almost certainly worked to depress pricing.

It is, after all, an ironclad rule of Economics 101: When supply goes up but demand remains steady, prices go down.

Bummer for breakfast

Unfortunately, there's a downside to this rule of economics. Namely, by artificially inflating supplies of the natural sweetener in 2012, Canada's thieves have necessarily decreased supply of syrup in 2013. Post-theft, Canada's producers simply don't have as much syrup on hand as they once thought they did.

This suggests that the new year could see higher prices for pure maple syrup than would otherwise have been the case. When combined with a poor corn harvest in the U.S. from this past summer's drought, that's likely to increase the cost of lower-quality syrups, such as the "maple-flavored" corn syrups sold in U.S. supermarkets, as well.

Moral of the story: Thanks to the Canadian Mounties, crime still doesn't pay for the criminals. Sadly, American breakfasters may still wind up paying more for their pancakes in 2013.

Motley Fool contributor Rich Smith thinks this would be a really sad story... but he still can't stop chuckling at the thought that Canada has a strategic syrup reserve.


Maple Syrup Heist: Three Arrested


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HP: We Might Unload Some Weaker Divisions (HPQ)

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Jan. 1 (Bloomberg) -- Hewlett-Packard Co. said it’s evaluating the disposition of businesses that don’t meet goals more than a year after Chief Executive Officer Meg Whitman said she didn’t plan to spin off the personal-computer division.

“We also continue to evaluate the potential disposition of assets and businesses that may no longer help us meet our objectives,” Hewlett-Packard said in a Dec. 27 10-K filing with the U.S. Securities and Exchange Commission. That language wasn’t included in the document a year earlier.

CEO since September 2011, Whitman is working to turn around Palo Alto, California-based Hewlett-Packard after five straight quarters of declining sales and years of botched deals, management tumult and strategic missteps. An $8.8 billion writedown of the acquired software company Autonomy Corp. in November renewed calls on Wall Street for Hewlett-Packard to realize shareholder value by shedding certain businesses, such as PCs and printers.

Hewlett-Packard, the world’s largest maker of personal computers and printers, discussed the evaluation in the “Risk Factors” section of its regulatory filing, saying that any disposal would have possible drawbacks.

“When we decide to sell assets or a business, we may encounter difficulty in finding buyers or alternative exit strategies on acceptable terms in a timely manner, which could delay the achievement of our strategic objectives,” Hewlett- Packard said.

Justice Investigation

Hewlett-Packard also said in the filing that the U.S. Justice Department had opened an investigation relating to Autonomy. Hewlett-Packard accused the software company of misrepresenting its performance before being bought in 2011.

The disclosure that Hewlett-Packard is evaluating disposing of assets or businesses came 14 months after Whitman said she would keep the company’s PC business in house. Her predecessor, Leo Apotheker, had explored a spinoff of the unit, which had $35.7 billion in sales in fiscal 2012, or 29 percent of the total.

Whitman instead unified the PC and printer groups’ management under Executive Vice President Todd Bradley last year. The printer unit accounted for $24.5 billion in fiscal 2012 revenue, or 20 percent of total sales.

Michael Thacker, a spokesman for Hewlett-Packard, declined to comment beyond the filing.

Hewlett-Packard’s filing said it may “dispose of a business at a price or on terms that are less desirable than we had anticipated.” In addition, “the impact of the divestiture on our revenue growth may be larger than projected,” according to the filing.

Shares of Hewlett-Packard gained 4.2 percent to $14.25 at yesterday’s close in New York. The shares declined 45 percent in 2012.

--Editors: Tom Giles, Jillian Ward

To contact the reporter on this story: Aaron Ricadela in San Francisco at aricadela@bloomberg.net

To contact the editor responsible for this story: Tom Giles at tgiles5@bloomberg.net

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Three CEOs Who Should Go in 2013

Out with the old and in with the new, that?s what many people tend to think if not say at certain times of the year. While there are a few times each year that present themselves as opportune moments for such thought and action, two usual candidates are spring cleaning and entering the new year. [...]

Source: http://www.forbes.com/sites/greatspeculations/2012/12/27/three-ceos-that-should-go-in-2013/

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AD OF THE DAY: Supermodel Gisele Bundchen Made Completely Out Of Salt

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SEE ALSO: AD OF THE DAY: Everything Important That Happened In 2012 ? In Under 3 Minutes

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Al Qaeda Has Basically Made Its Own Country In Africa

Mali AP DO NOT REUSE

MOPTI, Mali (AP) — Deep inside caves, in remote desert bases, in the escarpments and cliff faces of northern Mali, Islamic fighters are burrowing into the earth, erecting a formidable set of defenses to protect what has essentially become al-Qaida's new country.

They have used the bulldozers, earth movers and Caterpillar machines left behind by fleeing construction crews to dig what residents and local officials describe as an elaborate network of tunnels, trenches, shafts and ramparts. In just one case, inside a cave large enough to drive trucks into, they have stored up to 100 drums of gasoline, guaranteeing their fuel supply in the face of a foreign intervention, according to experts.

Northern Mali is now the biggest territory held by al-Qaida and its allies. And as the world hesitates, delaying a military intervention, the extremists who seized control of the area earlier this year are preparing for a war they boast will be worse than the decade-old struggle in Afghanistan.

"Al-Qaida never owned Afghanistan," said former United Nations diplomat Robert Fowler, a Canadian kidnapped and held for 130 days by al-Qaida's local chapter, whose fighters now control the main cities in the north. "They do own northern Mali."

Al-Qaida's affiliate in Africa has been a shadowy presence for years in the forests and deserts of Mali, a country hobbled by poverty and a relentless cycle of hunger. In recent months, the terror syndicate and its allies have taken advantage of political instability within the country to push out of their hiding place and into the towns, taking over an enormous territory which they are using to stock arms, train forces and prepare for global jihad.

The catalyst for the Islamic fighters was a military coup nine months ago that transformed Mali from a once-stable nation to the failed state it is today. On March 21, disgruntled soldiers invaded the presidential palace. The fall of the nation's democratically elected government at the hands of junior officers destroyed the military's command-and-control structure, creating the vacuum which allowed a mix of rebel groups to move in.

With no clear instructions from their higher-ups, the humiliated soldiers left to defend those towns tore off their uniforms, piled into trucks and beat a retreat as far as Mopti, roughly in the center of Mali. They abandoned everything north of this town to the advancing rebels, handing them an area that stretches over more than 620,000 square kilometers (240,000 square miles). It's a territory larger than Texas or France — and it's almost exactly the size of Afghanistan.

Turbaned fighters now control all the major towns in the north, carrying out amputations in public squares like the Taliban did. Just as in Afghanistan, they are flogging women for not covering up. Since taking control of Timbuktu, they have destroyed seven of the 16 mausoleums listed as world heritage sites.

Al-Qaida never owned Afghanistan ... They do own northern Mali

The area under their rule is mostly desert and sparsely populated, but analysts say that due to its size and the hostile nature of the terrain, rooting out the extremists here could prove even more difficult than it did in Afghanistan. Mali's former president has acknowledged, diplomatic cables show, that the country cannot patrol a frontier twice the length of the border between the United States and Mexico.

Al-Qaida in the Islamic Maghreb, known as AQIM, operates not just in Mali, but in a corridor along much of the northern Sahel. This 7,000-kilometer (4,300-mile) long ribbon of land runs across the widest part of Africa, and includes sections of Mauritania, Niger, Algeria, Libya, Burkina Faso and Chad.

"One could come up with a conceivable containment strategy for the Swat Valley," said Africa expert Peter Pham, an adviser to the U.S. military's African command center, referring to the region of Pakistan where the Pakistan Taliban have been based. "There's no containment strategy for the Sahel, which runs from the Atlantic Ocean to the Red Sea."

Earlier this year, the 15 nations in West Africa, including Mali, agreed on a proposal for the military to take back the north, and sought backing from the United Nations. Earlier this month, the Security Council authorized the intervention but imposed certain conditions, including training Mali's military, which is accused of serious human rights abuses since the coup. Diplomats say the intervention will likely not happen before September of 2013.

In the meantime, the Islamists are getting ready, according to elected officials and residents in Kidal, Timbuktu and Gao, including a day laborer hired by al-Qaida's local chapter to clear rocks and debris for one of their defenses. They spoke on condition of anonymity out of fear for their safety at the hands of the Islamists, who have previously accused those who speak to reporters of espionage.

The al-Qaida affiliate, which became part of the terror network in 2006, is one of three Islamist groups in northern Mali. The others are the Movement for the Unity and Jihad in West Africa, or MUJAO, based in Gao, and Ansar Dine, based in Kidal. Analysts agree that there is considerable overlap between the groups, and that all three can be considered sympathizers, even extensions, of al-Qaida.

The Islamic fighters have stolen equipment from construction companies, including more than $11 million worth from a French company called SOGEA-SATOM, according to Elie Arama, who works with the European Development Fund. The company had been contracted to build a European Union-financed highway in the north between Timbuktu and the village of Goma Coura. An employee of SOGEA-SATOM in Bamako declined to comment.

The official from Kidal said his constituents have reported seeing Islamic fighters with construction equipment riding in convoys behind 4-by-4 trucks draped with their signature black flag. His contacts among the fighters, including friends from secondary school, have told him they have created two bases, around 200 to 300 kilometers (120 and 180 miles) north of Kidal, in the austere, rocky desert.

The first base is occupied by al-Qaida's local fighters in the hills of Teghergharte, a region the official compared to Afghanistan's Tora Bora.

"The Islamists have dug tunnels, made roads, they've brought in generators, and solar panels in order to have electricity," he said. "They live inside the rocks."

Still further north, near Boghassa, is the second base, created by fighters from Ansar Dine. They too have used seized explosives, bulldozers and sledgehammers to make passages in the hills, he said.

In addition to creating defenses, the fighters are amassing supplies, experts said. A local who was taken by Islamists into a cave in the region of Kidal described an enormous room, where several cars were parked. Along the walls, he counted up to 100 barrels of gasoline, according to the man's testimony to New York-based Human Rights Watch.

MaliIn Timbuktu, the fighters are becoming more entrenched with each passing day, warned Mayor Ousmane Halle. Earlier in the year, he said, the Islamists left his city in a hurry after France called for an imminent military intervention. They returned when the U.N. released a report arguing for a more cautious approach.

"At first you could see that they were anxious," said Halle by telephone. "The more the date is pushed back, the more reinforcements they are able to get, the more prepared they become."

In the regional capital of Gao, a young man told The Associated Press that he and several others were offered 10,000 francs a day by al-Qaida's local commanders (around $20), a rate several times the normal wage, to clear rocks and debris, and dig trenches. The youth said he saw Caterpillars and earth movers inside an Islamist camp at a former Malian military base 7 kilometers (4 miles) from Gao.

The fighters are piling mountains of sand from the ground along the dirt roads to force cars onto the pavement, where they have checkpoints everywhere, he said. In addition, they are modifying their all-terrain vehicles to mount them with arms.

"On the backs of their cars, it looks like they are mounting pipes," he said, describing a shape he thinks might be a rocket or missile launcher. "They are preparing themselves. Everyone is scared."

A university student from Gao confirmed seeing the modified cars. He said he also saw deep holes dug on the sides of the highway, possibly to give protection to fighters shooting at cars, along with cement barriers with small holes for guns.

In Gao, residents routinely see Moktar Belmoktar, the one-eyed emir of the al-Qaida-linked cell that grabbed Fowler in 2008. Belmoktar, a native Algerian, traveled to Afghanistan in the 1980s and trained in Osama bin Laden's camp in Jalalabad, according to research by the Jamestown Foundation. His lieutenant Oumar Ould Hamaha, whom Fowler identified as one of his captors, brushed off questions about the tunnels and caves but said the fighters are prepared.

"We consider this land our land. It's an Islamic territory," he said, reached by telephone in an undisclosed location. "Right now our field of operation is Mali. If they bomb us, we are going to hit back everywhere."

He added that the threat of military intervention has helped recruit new fighters, including from Western countries.

In December, two U.S. citizens from Alabama were arrested on terrorism charges, accused of planning to fly to Morocco and travel by land to Mali to wage jihad, or holy war. Two French nationals have also been detained on suspicion of trying to travel to northern Mali to join the Islamists. Hamaha himself said he spent a month in France preaching his fundamentalist version of Islam in Parisian mosques after receiving a visa for all European Union countries in 2001.

Hamaha indicated the Islamists have inherited stores of Russian-made arms from former Malian army bases, as well as from the arsenal of toppled Libyan leader Moammar Gadhafi, a claim that military experts have confirmed.

Those weapons include the SA-7 and SA-2 surface-to-air missiles, according to Hamaha, which can shoot down aircrafts. His claim could not be verified, but Rudolph Atallah, the former counterterrorism director for Africa in the Office of the Secretary of Defense, said it makes sense.

"Gadhafi bought everything under the sun," said Atallah, a retired U.S. Air Force lieutenant colonel, who was a defense attache at the U.S. Embassy in Mali. "His weapons depots were packed with all kinds of stuff, so it's plausible that AQIM now has surface-to-air missiles."

Right now our field of operation is Mali. If they bomb us, we are going to hit back everywhere.

Depending on the model, these missiles can range far enough to bring down planes used by ill-equipped African air forces, although not those used by U.S. and other Western forces, he said. There is significant disagreement in the international community on whether Western countries will carry out the planned bombardments.

The Islamists' recent advances draw on al-Qaida in the Islamic Maghreb's near decade of experience in Mali's northern desert, where Fowler and his fellow U.N. colleague were held captive for four months in 2008, an experience he recounts in his recent book, "A Season in Hell."

Originally from Algeria, the fighters fled across the border into Mali in 2003, after kidnapping 32 European tourists. Over the next decade, they used the country's vast northern desert to hold French, Spanish, Swiss, German, British, Austrian, Italian and Canadian hostages, raising an estimated $89 million in ransom payments, according to Stratfor, a global intelligence company.

During this time, they also established relationships with local clans, nurturing the ties that now protect them. Several commanders have taken local wives, and Hamaha, whose family is from Kidal, confirmed that Belmoktar is married to his niece.

Fowler described being driven for days by jihadists who knew Mali's featureless terrain by heart, navigating valleys of identical dunes with nothing more than the direction of the sun as their map. He saw them drive up to a thorn tree in the middle of nowhere to find barrels of diesel fuel. Elsewhere, he saw them dig a pit in the sand and bury a bag of boots, marking the spot on a GPS for future use.

In his four-month-long captivity, Fowler never saw his captors refill at a gas station, or shop in a market. Yet they never ran out of gas. And although their diet was meager, they never ran out of food, a testament to the extensive supply network which they set up and are now refining and expanding.

Among the many challenges an invading army will face is the inhospitable terrain, Fowler said, which is so hot that at times "it was difficult to draw breath." A cable published by WikiLeaks from the U.S. Embassy in Bamako described how even the Malian troops deployed in the north before the coup could only work from 4 a.m. to 10 a.m., and spent the sunlight hours in the shade of their vehicles.

Yet Fowler said he saw al-Qaida fighters chant Quranic verses under the Sahara sun for hours, just one sign of their deep, ideological commitment.

"I have never seen a more focused group of young men," said Fowler, who now lives in Ottawa, Canada. "No one is sneaking off for R&R. They have left their wives and children behind. They believe they are on their way to paradise."

___

Associated Press writer Baba Ahmed contributed to this report from Bamako and Mopti, Mali.

___

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Pizza Hut Driver Claims He Was Demoted For Using Fiberglass Tent Pole To Fight Off Attackers

Life can be dangerous for pizza delivery drivers, who are often carrying cash and food and rarely have anyone to protect them. Now a Pizza Hut employee in Maryland says he’s been pulled off deliveries because he used a tent pole to defend himself against a group of attackers.

The man, a college student, tells FOX45 in Baltimore that he … [More]

Source: http://consumerist.com/2012/12/31/pizza-hut-driver-claims-he-was-demoted-for-using-fiberglass-tent-pole-to-fight-off-attackers/

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Amazon Explains Why It Took Netflix Offline On Christmas Eve (AMZN, NFLX)

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Amazon issued a long technical explanation and apology for the outage that took Netflix down on Christmas Eve, without ever mentioning the rival online-video service by name.

The outage lasted all night and part of Christmas Day.

Netflix was the most notable outage, but it wasn't the only one. Amazon's downtime affected other customers, like Salesforce.com's Heroku. And Because Heroku is itself a cloud service that hosts other company's apps, this mean that Amazon's outage affected all kinds of companies.

It did not, however, affect Amazon's own movie-streaming service that competes with Netflix, Amazon Instant Video.

On Saturday, Amazon explained that human error caused the initial problem.  Someone inadvertently deleted some very important data. It promised this particular error would never happen again:

"We want to apologize. We know how critical our services are to our customers’ businesses, and we know this disruption came at an inopportune time for some of our customers. We will do everything we can to learn from this event and use it to drive further improvement in the ELB service."

Because movie-watching is a big tradition on Christmas, it was Netflix's outage that created the most fuss. Netflix fielded a long string of tweets on its customer service account, @Netflixhelps, where it noted that Amazon was to blame.

This, of course, prompted a lot of witty tweets in response like this one:

The service was mostly restored by 10:30 a.m. Pacific Time on December 25, but it left people wondering if Netflix was wise to trust Amazon's cloud so thoroughly.

Last month, Netflix CEO Reed Hastings said that by the end of 2013, he wants Netflix to host 100% of its service on Amazon's cloud, which would make Netflix the biggest customer for Amazon Web Services.

Don't miss: Here Are The Hot New Technologies That Will Get Hundreds Of Millions Of Dollars In 2013

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