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Surgeons remain hopeful for Giffords

Doctors are monitoring her brain for swelling, which usually peaks three days after an injury, says a Tucson neurologist who adds that it is too early to assess the congresswoman's mental functioning.

January 11, 2011|By Thomas H. Maugh II, Los Angeles Times

Rep. Gabrielle Giffords' condition essentially remained unchanged overnight Sunday, doctors at University Medical Center in Tucson said in a Monday news conference.

"No change is good, and we have no change," said Dr. Michael Lemole, chief of neurosurgery at the medical center and one of the neurosurgeons who cared for Giffords after she was shot Saturday. "She is still following basic commands, and her CAT scans are showing no progression of swelling. Every day that goes by, we are slightly more optimistic."

Lemole said swelling of the brain typically peaked on the third day after an injury, which would be Tuesday. After that, "we can breathe a collective sigh of relief."

Surgeons removed most of the left side of her skull Saturday to prevent swelling from compressing her brain and cutting off the flow of blood to her brain stem, which would almost certainly be fatal.

The 9-millimeter bullet fired at her entered the back of her skull and exited through the front, passing only through the left hemisphere and, fortunately, missing the crucial area connecting the two hemispheres of the brain.

Had it struck that juncture, it would have been fatal or, at the very least, severely disabling, such as the wound that affected President Reagan's press secretary, James Brady, during an attempt on Reagan's life.

But the left hemisphere controls speech functions and the movement of the right side of the body, and physicians have not been able to assess how badly those functions have been damaged. Giffords is intubated, and thus unable to speak.

The team has refused to release any details about her condition, specifically which side of her body she is able to move in response to commands.

But Dr. Peter Rhee, chief of the hospital's trauma division, told the Associated Press that Giffords was moving fingers on her left hand in response to commands.

"When she did that, we were having a party in there," he said.

The crucial test will be whether she can move her right side, which is controlled by the left hemisphere.

And even while sedated, Rhee said, Giffords has reached for her breathing tube to try to remove it. "That's a purposeful movement. That's a great thing. She's always reaching for the tube."

But the doctors have no idea how the damage has affected her mental functioning. "At this point, we can't measure psychologic function, nor would we try," Lemole said.

Rhee said there were still eight patients from the shooting in the hospital. Two, including Giffords, are in intensive care, one listed in critical condition and one in serious. The remaining six are in regular hospital wards and are listed in good and fair conditions.

The other recovering victims had a variety of wounds, including injuries to the abdomen, bone, blood vessels, chest and extremities.

Rhee also said patients might start suffering from post-traumatic stress disorder. Psychologists were at the medical center to offer counseling to patients, some of whom have lost family and friends.

thomas.maugh@latimes.com

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