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Brain & Nervous System Health Center

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Gabrielle Giffords' Brain Injury: FAQ

Giffords Recovering from Point-Blank Gunshot to Head

Why was part of Giffords' skull removed?

After removing bone fragments from Giffords' brain, her doctors also removed a large section of her skull. This was done to give her bruised brain some room to swell.

If the bone had not been removed, the pressure inside her head might have built up to the point where it starved the brain of blood.

"You take the skull up, but you still have the scalp covering the brain," Black says. "Then once the swelling goes down you can go back and put in an artificial skull plate or even the skull piece itself. But most of the time in a head injury you don't keep the bone, because it is contaminated with hair and bullet. So you come back about four weeks later and replace it with acrylic bone plates."

What would be the signs that Giffords' condition is getting worse?

In the short term, brain swelling was Giffords' most serious threat. That threat now is greatly reduced.

Her doctors have replaced her respirator with a tube that goes directly into her windpipe. This helps protect the airway, but would make it difficult for her to speak.

There was also a risk of brain infection, but as time goes by this becomes less likely. And because Giffords suffered a very severe brain injury, seizure remains a serious risk.

Overall, Giffords is making a remarkable recovery. It now seems certain that she will leave the hospital -- possibly in a matter of days -- and begin her rehabilitation.

Once Giffords enters a rehab facility, a team of professionals will take over her care. That team will perform a thorough evaluation, and then begin her rehab regimen as soon as possible, says Mark A. Brooks, PhD, a neuropsychologist at Glancy Rehabilitation Hospital, Duluth, Ga.

"They will establish treatment goals and execute them the following day," Brooks tells WebMD. "You can't postpone treatment. The window of recovery is greatest early on. The more aggressive you are in the beginning, the better the outcome."

Will Giffords survive?

"Survival? We are beyond that phase," Flamm says. "What is of greater concern is the quality of survival."

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