On Friday, Senator John McCain (R-AZ) underwent surgery to remove a two-inch blood clot from “above his left eye” during a “minimally invasive craniotomy with an eyebrow incision” at the Mayo Clinic Hospital in Phoenix. The Senator’s staff said the clot was found during a “routine” annual physical. The problematic medical situation didn’t just affect Senator McCain, it also forced the delay of the new vote on the GOP healthcare bill.
CNN’s Dr. Sanjay Gupta explained that what sounded like a small medical procedure early on, may have actually been more serious than was let on:
Yeah, I think it was really sounding small. The way it was described initially an eyebrow incision to take out a blood clot. What the hospital released on Friday, to give a little more definition to what happened here. It was an eyebrow incision, which typically is done to try to hide the scar, but after that the skin was open, and actually the bone, underneath there, you can feel the bone right underneath your eyebrow, was also open, that’s called a craniotomy and that’s basically to gain access to the brain…
it’s a significant operation. Anytime your basically opening the bone to gain access to the brain, it’s a significant operation.
Over at the New York Times there are also questions about how “routine” this procedure was and if it portends a much bigger problem.
“Usually, a blood clot in this area would be a very concerning issue,” said Dr. Nrupen Baxi, an assistant professor of neurosurgery at the Albert Einstein College of Medicine in New York City.
He added, “The recovery time from a craniotomy is usually a few weeks.”
A statement from the Mayo Clinic Hospital said that the senator was recovering well and in good spirits at home, and that tissue pathology reports would come back in several days.
But many questions have been left unanswered, including whether Mr. McCain had symptoms that prompted doctors to look for the clot. In June, his somewhat confused questioning of James B. Comey, the former F.B.I. director, led to concerns about his mental status, which he later jokingly dismissed by saying he had stayed up too late watching baseball the night before.
“Usually, a blood clot like this is discovered when patients have symptoms, whether it’s a seizure or headaches or weakness or speech difficulties,” Dr. Baxi said. “Generally, it’s not found on a routine physical because doctors would not know to look for it.”
The cause of the clot has not been disclosed. The possibilities include a fall or a blow to the head, a stroke or certain brain changes associated with aging. Mr. McCain is 80.
It is worrisome, but the health professional that the New York Times spoke to had a positive prognosis for Senator McCain.
“I think the one possibility that’s of concern is that melanomas are known to go to the brain and they can bleed,” Dr. Stieg said. “They’ll have to wait for the pathology to come back. The good news is that five centimeters is a sizable blood clot, but in the frontal lobe, it should be well tolerated and hopefully he won’t have any neurologic deficits.”