|Gabrielle Giffords, following her 2010 election victory.|
In the aftermath of the shooting of Congresswoman Gabrielle Giffords on Saturday, many people are wondering about her chances of recovery. They're the best they can be, given advances in brain surgery, according to a neurosurgeon from Barrow Neurological Institute.
Giffords was shot in the head with a Glock handgun while making an appearance at a Safeway store in Tucson. She underwent surgery at the University of Arizona Medical Center and is heavily sedated. Surgeons removed part of her skull to reduce swelling in her brain. Doctors say she's able to communicate and are optimistic she'll survive, but she has a long recovery ahead of her.
If Giffords had been shot in 1963, the year that President John F. Kennedy was shot, she might not have survived.
According to Dr. Peter Nakaji, a neurological surgeon at the renowned Barrow Neurological Institute at St. Joseph's Hospital and Medical Center in Phoenix, advances in treating brain trauma have come a long way since the early 1960s.
"They were still capable of opening up [the skull] and letting off pressure, but there weren't even CAT scans at the time to see where the bullet was -- we only had X-rays, so [surgeons] were basically going blind," Nakaji says. "This was before Vietnam, so they probably tried to go in and dig out fragments and the bullets. But in Kennedy's case -- a direct hit from a high-velocity military rifle will almost always be fatal, as opposed to a hit from a handgun. That's probably the reason Gabrielle Giffords is still alive."
By the time former White House Press Secretary Jim Brady was shot in the head in 1981, "a lot of advances had been made," Nakaji says. "CAT scans were common, so it was possible to see the entry point and the damage. As far as surgical techniques, a lot of lessons were learned in Vietnam. We're gentler now, and the treatment is better-aimed."
Today, Nakaji says, one of the most important aspects of treating brain trauma is reducing swelling and pressure inside the skull. "We know the secondary injury is sometimes the most important part. We want to keep the brain around the damaged area intact," Nakaji says. "It's pretty standard today to remove part of the bone to keep the swelling down. Taking out that bone [skull] is like popping a cork of champagne -- it relieves the pressure. It seems like an extreme thing to do, but it allows the parts of the brain around the damaged area to heal, rather than die."
Dr. Nakaji has not treated Giffords' injury, but says from a neurosurgeon's standpoint, her prognosis isn't bad. "She got fast treatment, which is key," he says. "It's promising, what we're hearing, as far as her being able to hold up fingers and communicate a little non-verbally."
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