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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Source: http://www.dailyfinance.com/2013/01/01/maple-syrup-heist-could-make-your-pancake-breakfast-more-expensi/

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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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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

Brazil's Wunderman agency created a very cool commercial for Pantene shampoo.

The spot features a time lapse video of an artist creating an image of supermodel Gisele Bundchen entirely out of salt. It's quite amazing how accurate the picture is.

Check out the unique portrait here:

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

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