On January 8, 2011 the nation listened in horror as reports of an assassination attempt on Representative Gabrielle Giffords of Arizona were broadcast into their living rooms. After learning she had been shot in the head, to many of us, the outcome seemed sure to be devastating. Thankfully, Rep. Giffords is on the road to rehabilitation. But the true miracle is that she survived at all. How? A gunshot through the temple usually means certain death. Or does it?
The truth is although they are in the minority, people can and do survive serious gunshot injuries to the head in more cases than you may think. Approximately 1/3 of these types of patients do survive but only 50% of them live longer than 30 days. And of course, long-term neurological function is often severely compromised.
The way things look right now Giffords will be one of the few patients to beat the odds. So what tipped the odds in her favor?
It appears there are several factors at work here. First of all, she received almost immediate care and was undergoing surgery within 38 minutes of getting to the hospital. In addition, the bullet wasn’t lodged in her brain so there was a “through and through” injury. That makes a huge difference since the force of the bullet was not contained within her cranial cavity.
Also the bullet did not pass across the middle line of her brain. If that had been the case the likelihood of survival would drop significantly. Most of the brain’s major veins and arteries, as well as “control centers,” are more centralized. In addition, Giffords is young, in good health and her blood pressure was stabilized despite blood loss.
One very positive sign that Giffords would most likely survive was the fact that she could follow commands. That signifies a higher brain response than simply making movements. In other words she could hear, process, and execute commands from the doctors such as squeezing hands when asked to.
During surgery Gifford’s neurosurgeon performed a craniectomy to prevent the serious consequences of brain swelling. During this procedure a portion of the skull is removed. This was crucial to her positive outcome because the brain could swell without fear of crucial blood supply or brain tissue being compromised.
Since the assassination attempt representative Giffords has been able to move her hands and feet, open her eyes, and now is even able to stand. While in rehabilitation she will receive physical and occupational therapy, as well as language and speech therapy.
While the extent of her injuries and her longtime prognosis is yet to be defined, it is likely that Giffords will remain in an inpatient rehabilitation center for about a month. After that she may be able to rehabilitate as an outpatient of another facility or possibly even at home.
Who would have imagined such an amazing outcome could arise from a gunshot wound to the head? The brain is truly a mysterious and wondrous organ. For many people the way Giffords has made it through this ordeal continues to be a source of inspiration.
