Giffords' injury: "The bullet travelled the entire length of the brain on the left side..."

[Dennis Donovan]

...as per Dr Rhee at the presser now.

Shit, not good. :(

On edit: :eyes: need more coffee, I guess... :blush:

[CreekDog]

1. Giffords not Jeffords

[Dennis Donovan]

5. All day yesterday, I made this same mistake...

NO idea why.:shrug::blush:

[SoCalDem]

2. Oops.. It's Giffords

:)

[Dennis Donovan]

6. I probably posted about Jeffords 10 years ago...

...almost to the day.;)

[Horse with no Name]

3. But, it didn't cross the hemispheres

which is an excellent thing.

[Dennis Donovan]

9. But the left hemisphere controls speech, reasoning, etc...

...and it passed the entire length of the brain, front to back. She on a ventilator. Not a good thing...:(

[LisaL]

10. People have lived after the whole hemisphere has been removed.

[JDPriestly]

14. What happens to cognitive ability when the entire left brain is gone?

That may not be what happened, but as a hypothetical, what happens?

[Posteritatis]

26. There's actually a surgical procedure to do that

Hemispherectomy, which is exactly what it sounds like. Obviously it's a very extreme procedure, but there's people who have undergone it at an early enough age (while the brain is still more malleable) who have gone on to graduate studies and the like.

Of course, anything that dramatic is going to have very different effects on different people for any number of reasons, though.

[LisaL]

39. Young children can do great after the whole hemisphere has

been removed. Of course Rep. Giffords is not a young child so who knows what kind of cognitive abilities she will be left with after this.

[Horse with no Name]

17. But she is following simple commands

which means that she has cognitive function.
She is on a ventilator because she is in a medically induced coma.
They don't want her body doing any work until it can heal a little.

[TwilightGardener]

18. It's normal to be on a ventilator in her case--anyone who's not conscious

or is heavily sedated will be on a vent, to protect the airway and allow for suctioning of secretions. It doesn't necessarily mean that her brain's respiratory control has been knocked out, though that can happen with swelling inside the skull, certainly.

[northernlights]

29. not necessariy. anybody know if she is left or right handed? or ambidextrous?

because that would be a good clue. Both hemispheres participate. However, the dominant hemisphere controls use and understanding of language and complex computations and analysis.

90% of the population has a left dominant hemisphere. In the other 10%, the right side is dominant or they are used equally.

[Horse with no Name]

38. I was just repeating what the doc said

paraphrased "It is very good that the bullet didn't penetrate the hemisphere. It makes the recovery easier".

[lapfog_1]

13. More important... didn't hit the brain stem

and it didn't bounce off the back of the skull.

But still, I don't think she is going to come out of this in 6 to 8 weeks with no ill effects.

Very often people that survive a through and through gunshot to the brain are left with memory problems, some motor skill issues, and personality changes.

[Ptah]

4. But what about Giffords?

:wtf:

[Dennis Donovan]

7. WTF, indeed!

:blush: my bad.

[LisaL]

8. It actually is good because it was on one side.

[backscatter712]

11. That's what I keep hearing.

And I'm reminded that one treatment for epilepsy is to remove an entire brain hemisphere.

Neurosurgeons will only do that as a last resort, and usually only to children, as their brains can more easily recover, but yes, there are people out walking and talking and living with an entire half of their brain gone.

[Dennis Donovan]

21. Better than laterally or down the center...

...but they said it traveled the entire length of the brain, the left side. The right side would've been a less severe wound, per Sanjay Gupta this morning.

[baldguy]

12. Left brain = language

Like you said, not good.

[bhikkhu]

44. The left brain/right brain division is far less simple than that

Sperry was the first guy to propose it, and he said later that he regretted having done so. Its just the sort of general simplification people need when approaching a complex situation, but in reality the brain organization of every individual differs and there may be no actual brain that conforms very closely to the proposed left brain/right brain division of duties.

Which is just to say, jumping to any kind of conclusion at this point serves no purpose.

[baldguy]

46. But it still may be months or years before she'll be recovered.

Even if nothing else is damaged - reason, memory, understanding speech, her emotional control, personality - she may not be able to speak clearly, if at all, for a long time.

[bhikkhu]

49. ...hoping for the best

everything in the brain tends to be there for a good reason, so any loss tends to be a real loss of something, but its pretty early to tell.

[Warpy]

15. If she was talking, it likely missed the speech center

but she'll definitely need a prolonged period of rehab once they're able to allow her to wake up and wean off the ventilator.

[Horse with no Name]

19. Doc said she hasn't spoken

BUT she is following simple commands.

[Posteritatis]

24. Does that suggest that part of the brain is likely intact?

I have no idea if the languge output section of the brain and the language input section are the same, or near one another or the like.

[Horse with no Name]

37. The part that understands is apparently intact

Speech part won't be evident until she is fully awake and the tube taken out of her throat.

[Posteritatis]

41. Yeah, I just wasn't sure if those were both processed in the same place or not. (nt)

[Warpy]

31. Thanks, I slept too late to catch any sort of news this morning.

Intensive speech rehab can work miracles, though. I've seen it in action.

They won't know much of anything until the swelling subsides and they can get her off sedation and wean her off the ventilator.

[RamboLiberal]

20. She wasn't talking

Witness at scene who is an intern and helped treat her initially said she didn't talk but could hear him and squeezed his hand on command. Doctors today made it clear she was following commands to hold up fingers, etc. At moment she is on venilator so they don't yet know if she can speak.

[Joe the Revelator]

33. My father had a stroke that effected his speech centers....he "talks"...its just a lot different

very difficult to hold a conversation. That alone "aged" his 20 years.

[Odin2005]

45. Aphasia.

[oldlib]

16. She may have been fortunate

that he fired at such a close range. The bullet was at maximum velocity and passed through the brain so swiftly that the damage was minimized. I am not an expert and this is only a supposition on my part.

[northernlights]

23. my gut response was the same...

I know nothing about guns or gun wounds, but it seems that with more force, the bullet would travel a narrower path. As opposed to entering, hitting the bone on opposite side and shattering, or richocheting inside the head...

[RamboLiberal]

27. Could also depend on the type of bullet

No info yet of type of ammunition. 9mm is one of the smaller of the "major" calibers, hence smaller wound channel. It is also a fairly high speed round so it will go through quickly. And don't know if he was using ball or hollowpoints. Hollowpoints may expand which would make a more devastating & larger wound channel.

[Joe the Revelator]

35. If it was a "through and through" shot, as they are saying it was not a hollow point

It would have been a full metal jacket.

[RamboLiberal]

42. Not necessarily

9mm has a high FPS and can exit. Skull is a relatively small area. But if a hollow point it would probably have left a large exit wound. Without more info it's just a guess but I'd tend to believe he used a FMJ.

[northernlights]

22. that is "good" relatively speaking

my gut response is, from memory, the area of the brain where we interpret is in the middle. So if it traveled to one side or the other, that area may not be affected.

Now I have my Hole's anatomy in front of me and I see my memory was correct (3 years since I took anatomy) -- general interpretive area of the brain is dead center. Also, the visual area is center/rear and motor speech (Broca's area) center/front.

Other than that, front-back or back-front hits part of pretty much something everything: visual recognition, sensory interpretation, visual/auditory memory.

The rest depends I think on how high or low it traveled and angle (low to high versus high to low). Above center are voluntary muscle control, frontal eye field, contentration/planning/problem solving, sensory areas, understanding speech. Below center is interpretation of sensory experiences, and visual/auditory memory and patterns.

[nolabear]

25. This is conjecture but it's likely very good that it passed clear through.

The brain is pretty plastic, even in adults, up to a point. The fact that the bullet didn't lodge or ricochet in the congresswoman's brain might mean the path of damage is far more contained than it would be otherwise. Other areas can still develop control over some functions. (My god, what a thing to even have to think about). Best case would be if it missed major connective sites and places that control major functions.

Honestly, though, we just won't know for a while.

[RamboLiberal]

30. Agree - also means they had to do less surgical intervention

Encouraging they said they only had to remove a small amount of damaged brain tissue.

[eilen]

28. I've worked with patients with TBI (Traumatic Brain Injury)

as well as stroke victims who have had the left side of the brain affected. It is a tragedy of incredible proportion.

Even if she gets off the vent, she will never be the same again. Her right side will likely be paralyzed. Her memory, logic and reasoning may likely be severely impaired. She is so young for this. I hope they successfully sue the hell out of Palin and her ilk because it is going to be an expensive rest of her life -- care-wise.

[northernlights]

34. were they left or right handed?

Because wouldn't it be the opposite for somebody left-handed? Wouldn't their hemisphere dominance be the opposite?

[eilen]

43. yes it is opposite but after an injury like this

strength, gross and fine motors skills are degraded and require months and months of physical and occupational therapy to rebuild.

[northernlights]

48. there is no question about that

but if she is left handed, then the right side of her brain is dominant. I'm thinking of her language and complex analytical ability...damage to her mind, as opposed to her body.

[Joe the Revelator]

36. I was going to say the same thing. This is a complete life changer

No matter how minimal the damage, the Gabby Gifford's from Saturday morning is dead, which is tragic for her family.

[LisaL]

40. I think chances of successfully suing Palin over this are nill to none.

[Statistical]

32. Actually that is the least damaging angle, "as good as it gets".

Far worse is a bullet that crosses both left and right side and the worst is one that damages brain stem.

As far as headshots go a through and through limited to only one side (front to back) is basically as good as it gets.

[Lucian]

47. That doesn't sound good.

:(

I hope she makes a full recovery. I hear she's responding to people now, which is a good sign.