THURSDAY, May 19 (HealthDay News) -- Rep. Gabrielle Giffords
continued her remarkable recovery Thursday, one day after doctors
inserted a plastic implant to replace the piece of skull that had
been removed after she was shot in the head by a would-be assassin
four months ago.
The Arizona congresswoman is "recovering well after her surgery
today," read a Wednesday statement from TIRR Memorial Hermann
Hospital in Houston, where the surgery was performed, the
Associated Press reported.
Doctors removed the portion of skull to ease pressure on her
brain, which swelled after she was shot.
Still, her doctors said Giffords continues to face a long road
to recovery, and have repeatedly talked about reaching a new
Wednesday's surgery, the latest step in a recovery described as
miraculous, came only days after Giffords traveled to Florida to
see her husband, Mark Kelly, rocket into space as commander of the
space shuttle Endeavour's last mission.
While the latest surgery is a major move forward, it will have
no effect on her neurological status, and any speech or other
therapy will continue, according to one expert, Dr. Anders Cohen,
chief of neurosurgery at The Brooklyn Hospital Center in New York
"This is part of the recovery," Cohen said. "This is on the happier side, because it is not lifesaving. Swelling is no longer an issue, so let's protect the brain and let's give her a better cosmetic look. It's a quick thing with a fast recovery," he said.
After the shooting in Tucson, which killed six people and
wounded 12 others, doctors removed a large piece of Giffords' skull
to give the brain room to swell. It's likely that the bullet that
pierced her brain also shattered the bone, experts said.
Cohen, who is not involved in Giffords' care but is familiar
with news reports about her progress, said surgeons usually remove
a piece of skull about the size of a hand. Had the skull remained
intact, significant brain damage and even death might have
occurred, he said.
"When the brain swells, the skull, which usually protects the brain, becomes your worst enemy," he explained.
Replacement surgery isn't done until the swelling stops and the
brain has shrunk back to its normal size, Cohen added.
The replacement piece would probably be a custom-made plastic
implant that fits the opening perfectly, said Dr. Ricky Madhok, a
neurosurgeon at North Shore University Hospital in Manhasset, N.Y.,
and Nassau University Medical Center in East Meadow, N.Y. It is
meant to protect the brain and give her head a natural appearance,
"To replace the part of the skull, certain types of plastic can be used to recreate the skull," explained Madhok, who was not involved in Giffords' surgery. "Keep in mind, the purpose of the skull is to provide a protective barrier to the brain, whether that is done by bone or by a specially designed plastic."
The technology for these replacement implants is now very
advanced, he added. "One of the biggest things to be developed in
this area is custom designed implants," Madhok said. "As such,
using finely cut CT scans, each implant can be made to fit and
recreate the skull in such a way that the overall fit is as if the
original bone itself was replaced."
"Within a week, you get a ready-made prosthetic that exactly matches the defect," Cohen added.
"As soon as you close the scalp, the patient looks symmetrical again. The cosmetic result is very striking right from the get-go," Cohen said. "They look like themselves again right away."
For more on head injuries, visit the
U.S. National Library of Medicine.
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