When Rep. Gabrielle Giffords was shot Saturday, the bullet likely entered
the front of her skull, passed through the left side of her brain and
exited the back. Amazingly, she now has a "101 percent chance of
survival" according to Dr. Peter Rhee, the director of medical trauma at
her hospital. Rhee is also optimistic
that she's not going to be in a vegetative state in the months and
years to come. If she continues to recover, as doctors predict, she will
have survived an injury that is fatal 90% of the time.
To get a better sense of the dynamics of a gunshot wound to the head
and the recovery process, we've rounded up interviews and reports from
medical experts across the web. Here's how Giffords's body reacted to
the bullet and what her prospects are for returning to politics:
First Impact "A bullet first destroys tissue that lies in its path, which for Giffords was on the left side of the brain," explains Erika Check Hayden
at Nature News. "But it also damages neurons that don't lie directly in
its path, because it is trailed by a pressure wave that transfers the
energy of the bullet into the surrounding brain tissue. This pressure
wave activates all the neurons through which it passes. The neurons then
attempt to restore their resting electrochemical balance by absorbing
water, resulting in brain swelling."
"During surgery, the doctors at Arizona's University Medical Center
removed a large portion of Giffords' skull to allow the brain to swell
without being damaged," explains Tracy Staedter
at Discovery News. "They also used drugs to induce a coma, which slows
the metabolism and blood flow in the brain, decreasing pressure."
"Over the last several days, Ms. Giffords has repeatedly given
nonverbal responses to her doctors' commands, they said, and CAT scan
X-rays have shown that there is no swelling, which continues to be the
most serious threat," reports Jennifer Medina
at The New York Times. "So far, doctors said, she has shown only slight
movement on the right side of her body, raising questions about her
functional neurological status. Doctors again declined to give some
specific details about Ms. Giffords."
Sometimes Bullet Wounds Are Less Pernicious
"Neurosurgeons distinguish between 'penetrating' injuries, such as
bullets that go through the brain, and 'blunt' injuries, which refer to
the trauma of hitting one's head against an object or the floor,"
reports Elizabeth Landau
at CNN. "A bullet creates a focused wound to the brain, concentrated in
one area, while a concussion or other blunt injury creates more diffuse
harm ... Because it's easier to know which tissue is damaged, a focused
wound can be better from the surgeon's point of view ... However, in some
cases, the blast wave of a bullet can spread through brain tissue,
impacting multiple areas."
Bob Woodruff Comparison The ABC News anchor faced a similar head injury via a roadside bomb in Iraq. Woodruff, who continues to report for ABC, says
the chances for Giffords's recovery look better than his did at the time:
"In one way her case is more hopeful. She responded to verbal commands
by the doctors and reacted by squeezing their finger, indicating she
understood, although she could not speak. I never heard the words and
never squeezed my doctors' fingers when they tried to get me to
Long-Term Complications Erika Check Hayden at Nature News explains the potential lasting effects:
if Giffords recovers most of her movement and thinking skills, she
could suffer from a range of other lifelong complications; for example,
she will have an increased risk of developing dementia or Parkinson's
disease. Up to 50% of people who have a penetrating brain injury also go
on to develop epilepsy, perhaps because bleeding in the brain after an
injury exposes it to high doses of seizure-associated chemicals called
haemosiderins, which arise as haemoglobins in the blood break down. Many
patients with injuries to the left sides of their brains also
experience depression, because a region on the left front of the brain
is involved in mood control.
The Atlantic Wire is your authoritative guide to the news and ideas that matter most right now. Our team tracks newsmakers and opinions across the entire media spectrum: newspapers, web sites, television, radio and magazines.
But we do more than just collect information. By synthesizing, analyzing and summarizing what’s out there, and adding new information when we can, we are a news engine that gives you a quick and valuable account of the issues of the day.