Gabrielle Giffords' Brain Injury: FAQ
Giffords Recovering from Point-Blank Gunshot to Head
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What would be the signs that Giffords' condition is getting worse? continued...
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."
Black says he's seen patients who have been shot in the head make amazing recoveries.
"We have had patients who have been shot in the head and were able to return to their previous occupations and are functioning near normal," he says. "This may have to occur on a gradual basis. ... The brain will continue to recover for six to 18 months."
The parts of the brain destroyed by the bullet are gone forever. But other injured areas may recover.
"Some brain cells now in shock are still alive and those cells will go ahead and recover once the initial trauma is resolved," Black says. "The cells that were destroyed and died, the surrounding areas will try to take over those functions by making new connections. And there are stem cells in the brain that can come out and regenerate some of the tissue."
Brooks notes that while the brain cells destroyed during Giffords' injury are gone, the damage may be limited.
"A bullet wound is more like a stroke than a blow to the head from a car wreck, because the tissue damage is so circumscribed," he says. "The potential for recovery is greater for the tissue that didn't get taken out."
Will Giffords recover?
As Flamm notes, survival is one thing and recovery is another. It's very rare for a person with extensive brain damage -- such as that caused by a bullet -- to regain all of the abilities and functions he or she had before the injury.
So far, the news from Giffords' bedside is good. But until she is formally evaluated by a team of rehabilitation specialists, the extent of her disabilities remains unclear.