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Dural Vein Thrombosis

Enjoying the killer headache that's been drilling into the back of your skull for two weeks? You've been to the emergency room and gotten a CT scan or MRI of the brain -- maybe even a spinal tap. Don't get discouraged -- you could still have a diagnosis scary enough to turn your doctor's hair white! Your headache could be coming from a fat wormlike clot lodged in one of the veins of your dural sinuses, leaving your brain swollen and congested with blood that -- once pumped into your head -- has no way of getting out.

Maybe you're skeptical that such a diagnosis could have been missed after all those tests. However, those doctors were searching for bleeding aneurysms or brain tumors. It's harder to spot clots clogging the normally sluggishly blood flowing in veins that drain your brain through the dural sinus cavities, making it an easy diagnosis to miss in lots of patients -- including you. With 20% of your cardiac output entering your head and outflow channels blocked, pressure in he brain begins to build -- pushing out your optic nerves, causing tiny hemorrhages, seizures or odd neurological symptoms that may mimic a stroke and kill as many as 10% of victims. Even worse -- treatment with anticoagulants is the exact opposite of the recommended care for hemorrhagic headaches. Your doctor is likely hesitate before writing the order -- wondering if the drugs could kill you.

Who gets a rare three-in-a-million illness like dural vein thrombosis? Middle-aged women (75% of cases), smokers and families with blood coagulation disorders are at risk -- or people like secretary of State and former first lady Hillary Rodham-Clinton, who nursed the diagnosis for weeks before the condition was finally diagnosed.

Fortunately -- like Clinton -- you can hope for a complete recovery. No surgery is necessary. The veins remodel as the blood clots slowly break down, and once the acute phase of thrombosis is past, the pressure will ease and the headache and symptoms will go away for good -- making you the envy of the less fortunate friends you've left behind in the neuro-intensive care unit.

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