Brain blood clots rare, experts say

Brain blood clots rare, experts say
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POSTED: Thursday, June 13, 2013 - 9:30am

UPDATED: Thursday, June 13, 2013 - 1:34pm

Mumford & Sons bassist Ted Dwane received emergency treatment this week after doctors found that he had a blood clot on the surface of his brain.

The Grammy-winning group postponed several shows, saying Dwane sought treatment after "feeling unwell for a few days." The clot required an operation.

"Ted is receiving excellent care and we are being assured that he will recover quickly from surgery," the group said on its website.

In December, then-Secretary of State Hillary Clinton was also hospitalized for a blood clot that formed after she fell and suffered a concussion. Clinton's clot was in the vein in the space between the brain and the skull behind her right ear, officials said.

While little is known about Dwane's clot and its location, Dr. Mary Cushman, director of the Thrombosis and Hemostasis Program at the University of Vermont and chairwoman of the American Society of Hematology's subcommittee on quality of care, said in December that Clinton's type of clot was called a cerebral venous thrombosis and is relatively rare.

A two-year study conducted in the Netherlands found that cerebral venous thrombosis affects approximately 1 in every 100,000 people. In comparison, the Centers for Disease Control and Prevention says 1 in 1,000 people are affected by deep-vein thrombosis, a similar clot found most often in the leg.

Clinton had a DVT in 1998. "There are a handful of genetic conditions that predispose someone to these kinds of clots," Cushman said. "That's why you might see two different (types of blood clots) in the same person."

Risk factors for DVT include smoking, use of oral contraceptives, age (the risk increases over age 65) and obesity.

A large long-term study published in the journal PLoS One in 2007 found that the more frequently a person travels, the higher their risk of blood clots.

The blood in veins is fighting gravity to get back to the heart, Cushman said, and needs the leg muscles to help push it along. When a person is sedentary for long periods of time -- especially on a plane or in a car, where the legs are in the same position for hours -- the blood can start to clot.

Blood thinners are considered standard treatment after a blood clot, experts said.

"The current recommendations are for at least three months of treatment with a blood thinner following a clot," Dr. Evan Lipsitz, chief of vascular surgery at New York's Montefiore Medical Center, said in December. He was not involved in Clinton's care.

"Each case much be individualized depending on the size and location of the clot and the risk of bleeding as a result of the treatment," he said.

Often, patients on these medications are monitored closely, having their blood checked once a month or every couple of months to ensure that the dosage is right.

Lipsitz makes his patients aware of typical blood clot symptoms (sudden pain or swelling in the limbs, or chest pain and shortness of breath caused by a blood clot traveling toward the lungs) so they can spot them and get treated quickly. 

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