* No stroke or neurological damage detected, doctors say
* Clinton can leave hospital when blood thinner dosage set
* No long-term ill effects from clot anticipated
* Secretary of state suffered concussion in mid-December
By Arshad Mohammed and Jilian Mincer
WASHINGTON/NEW YORK, Dec 31 U.S. Secretary of
State Hillary Clinton suffered a blood clot in a vein between
her brain and skull behind her right ear but is expected to make
a full recovery, her doctors said on Monday in a statement
released by the State Department.
Clinton did not suffer a stroke or neurological damage as a
result of the clot, the doctors said, adding that "she is in
good spirits, engaging with her doctors, her family and her
The U.S. secretary of state, who has not been seen in public
since Dec. 7, was revealed on Sunday evening to be in a New York
hospital under treatment for a blood clot that stemmed from a
concussion she suffered in mid-December.
The concussion was itself the result of an earlier illness,
described by the State Department as a stomach virus she had
picked up during a trip to Europe that led to dehydration and a
fainting spell after she returned to the United States.
"In the course of a routine follow-up MRI on Sunday, the
scan revealed that a right transverse sinus venous thrombosis
had formed. This is a clot in the vein that is situated in the
space between the brain and the skull behind the right ear,"
Clinton's doctors, Drs. Lisa Bardack and Gigi El-Bayoumi said in
the statement released by the State Department.
"To help dissolve this clot, her medical team began treating
the Secretary with blood thinners. She will be released once the
medication dose has been established," the doctors said. "In all
other aspects of her recovery, the Secretary is making excellent
progress and we are confident she will make a full recovery."
MAY RAISE QUESTIONS ABOUT ANY WHITE HOUSE RUN
Clinton's illness may raise questions about her fitness to
be president should she make a new run for the White House in
2016. Barack Obama defeated her in the 2008 Democratic primary
and then, upon his election as president, took the unusual step
of tapping her for the most important post in his Cabinet.
Clinton earlier this month played down the notion that she
would run again for the White House in 2016, telling a TV
interviewer: "I've said I really don't believe that that's
something I will do again. I am so grateful I had the experience
of doing it before."
The former first lady turned U.S. senator from New York
turned diplomat has played down talk of possibly making another
White House run. She is expected to step down when her
replacement as secretary of state, Senator John Kerry, is
confirmed by the Senate.
Clinton has kept up a punishing schedule as the top U.S.
diplomat, flying more than 950,000 miles to visit 112 countries
and spending more than a quarter of her tenure - 401 days - on
the road, according to the State Department.
Her health setbacks have forced her to cancel an overseas
trip and postpone testimony to Congress regarding a report on
the deadly attack on the U.S. diplomatic post in Benghazi,
Libya. Her two deputies testified instead.
Clinton has said she intends to appear before Congress to
discuss the attack - in which four Americans, including the U.S.
ambassador to Libya, died - but it is unclear when she will be
back at work.
The doctors gave no estimate of when she may go home from
On Sunday, a State Department spokesman said Clinton was
"being treated with anti-coagulants and is at New
York-Presbyterian Hospital so that they can monitor the
medication over the next 48 hours."
'PIPES' DRAIN BLOOD FROM THE BRAIN
Clinton's condition is unusual, but by no means unheard-of.
"This condition is not very common, but it certainly
happens," said Dr. Raj Narayan, chair of neurosurgery at North
Shore University Hospital and Long Island Jewish Medical Center
in New York. It probably happens more often than we realize, he
said, because it must be diagnosed with an MRI, as Clinton's
Narayan, who is not treating Clinton, said it likely was
caused by her dehydration and the concussion that occurred from
her fall. Head trauma can cause blood clots, Narayan said,
because the injury triggers the production of thromboplastin, a
blood protein that causes the blood to clot.
The severity depends in part on how someone is built, he
People normally have two of the veins where Clinton suffered
the clot. Some people, however, have only one, while others have
two but one is much larger than the other. The prognosis is
typically better if you have two normal veins because the blood
could flow through the other vein if one is blocked.
"Think of it as two pipes draining all of the blood out of
the brain," Narayan said. "If one is blocked and the other is
open, there is no problem. But if both pipes are blocked, you
are in trouble."
Dr. Geoffrey Manley, chief of neurosurgery at San Francisco
General Hospital and professor of neurosurgery at the University
of California San Francisco (UCSF), said the condition can be
fatal if not treated but that most patients recover well.
"Left untreated, these things could be fatal. But typically,
injuries to the transverse sinus, if treated appropriately,
patients typically do very well," Manley said.
Manley, who is also not involved in Clinton's treatment,
said it was quite possible she would be out of the hospital in a
week or less and the condition was not likely to have long-term
effects or to be the harbinger of more clots over time.
"One doesn't necessarily dictate another one," he said.
"This is ultimately not going to cause any long-term brain
problems for her, and I think that it's a message to the public
that when you fall and hit your head, you need to be evaluated
by somebody that takes care of brain-injured patients," he