Did John McCain Have Surgery for a Subdural Hematoma

A blood clot in John McCain’s head has caused confusion, not necessarily on the part of the senator.

On Saturday evening, multiple news organizations reported that McCain had been hospitalized for removal of a blood clot “above his left eye.” This was based on a statement from McCain’s office, which said he “underwent a procedure to remove a blood clot from above his left eye.”

The phrasing was accurate, if potentially misleading, taken in isolation.

The clot was technically above McCain’s eyeball, meaning inside the skull, as is made clear by the rest of the senator’s statement: “Surgeons successfully removed the five-centimeter blood clot during a minimally invasive craniotomy with an eyebrow incision.”

Though the precise location of the clot has not been disclosed by the senator and his medical team, excising a superficial clot on a person’s face would be a rare procedure. And it should not involve craniotomy, a hole in the skull.

Craniotomy is always a serious procedure, so “minimimally invasive” could sound like downplaying, but it’s a common phrase among neurosurgeons, drawing contrast to an “open” craniotomy, in which a section of skull is removed. The minimally invasive, or “keyhole,” craniotomy involves a small burr hole and faster recovery. In this case, above McCain’s left eye.

So all of this is what’s known based on the brief report from McCain’s office, which managed to spark a wave of armchair-theorizing from doctors. For example, in the Donald Trump subreddit, one user wrote in a popular post: “Fake news has EVERYTHING wrong. First off, I’m a physician. There are reports of John McCain having a ‘clot above his eye removed.’ I was curious. This is a very odd thing to say, as it doesn’t really happen. … FACTS: They said it was a five centimeter clot. There isn’t enough room in the orbit (around the eyeball) for a five cm clot. They referred to it as a craniotomy, i.e., they…

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