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Blood clots can lead to stroke and even death if not caught early

Dr. James L. Frazier

Secretary of State Hillary Rodham Clinton recently received a gag gift of protective headgear after she suffered a concussion and blood clot near her brain after a fall. While Clinton can now make light of the injuries, a blood clot can be a serious health risk that can lead to death. Dr. James L. Frazier, III, a neurosurgeon at Mercy Medical Center in Baltimore, talks about the dangers.

What causes a blood clot to form in the brain?

A blood clot or thrombus can form in the arteries that supply blood to the brain. Such a clot may be caused due to fatty deposits or plaque that build up in the arteries. This results in reduced blood flow, what is known as atherosclerosis. Blood clots can also form due to an injury, such as trauma to the head, or in the venous sinuses due to other underlying conditions.

When is it most dangerous?

A clot can break off and travel to another part of the body — this can be dangerous should the clot travel to the lungs, leading to a pulmonary embolism, a life-threatening scenario, or to the brain, where it can cause a stroke. A blood clot in an artery or venous sinus can significantly reduce blood flow and cause a devastating stroke. A blood clot caused by trauma can expand and lead to a life-threatening scenario.

How do you detect a blood clot? Is there any way of knowing without doing an MRI?

In the case of a blood clot in the leg, you may notice the area to be swollen, red and warm to the touch. You may notice a tenderness or aching pain. To determine if it is a blood clot, there are a variety of tests a physician may order. For example, a blood test done to check D-dimer levels. D-dimer is a substance in the blood that dissolves clots and may be elevated in people who have blood clots. This is not a definitive test, however. You may undergo imaging tests, like MRIs, CT scans or ultrasounds to see if a blood clot actually exists. You may also have a vein scan; this involves injecting a radioactive agent, called a tracer, into your vein. A scan is done after the tracer has had a chance to get into your bloodstream. The blood clot will be seen as a bright spot on the screen.

How is a blood clot treated?

Typically, your body will naturally dissolve the blood clot after the injury has healed. Sometimes, however, clots form on the inside of vessels without an obvious injury or do not dissolve naturally.

Blood clots are treated differently depending on the location of the clot and your health. Some current treatments include:

•Anticoagulants — medicine that prevents clots from forming

•Clot busters — medicine that dissolves blood clots

•Catheter-directed thrombolysis — a procedure in which a long tube, called a catheter, is surgically inserted and directed toward the blood clot where it delivers clot-dissolving medication

•Thrombectomy — surgical removal of a clot

What happens to the brain if a blood clot is not detected in time?

A devastating stroke may occur. In some cases, death may occur.