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August 19, 2016

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Gerardgianoli

Drew, I share you concerns about diagnosing someone without the benefit of a personal evaluation. I also am not especially happy about some of the wild speculation about Ms. Clinton's health. We need more information.

That said, if we can rely on the Mrs. Clinton to provide us truthful information, there are some things that we do not need to speculate about. The two that fall into my area of expertise are the concussion and the right transverse venous sinus thrombosis. I've treated lots of patients with both of these (as well as having resected transverse sinus for tumor removal, and dealing with the consequences thereof). The thing that we know about thrombosis and blockage of the TVS is that it will cause elevation of ICP. It's just a question of how much and how bad are the symptoms. (I have a special interest in ICP and collaborated with NASA for a non-invasive device that is now approved for use in the Space Station). Similarly, with a concussion that takes "6 months toe recover from", the question becomes are there any long term sequelae. So, I am not making any diagnosis of Mrs. Clinton - that's already been made by her doctors. I just want to know what are (if any) the long term sequelae. A release of her Neurologists report, post-concussive tests and her Ophthalmologist report should help answer these questions.

Going forward, this will loom as a bigger and bigger question for future presidential candidates as we will certainly see older candidates become more common. Let's face it. At 69-70 years old, most people have significantly medical problems, but not all. The degree of health or illness at that age will be widely dispersed.

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