- Associated Press - Monday, January 10, 2011

TUCSON, Ariz. (AP) — Doctors said Monday that Rep. Gabrielle Giffords‘ brain remains swollen, but the pressure isn’t increasing — a good sign for the congresswoman’s recovery.

Dr. G. Michael Lemole Jr., Mrs. Giffords‘ neurosurgeon at Tucson’s University Medical Center, said her condition is stable.

“That’s why we are much more optimistic, and we can breathe a collective sigh of relief after about the third day,” he told reporters.

Dr. Lemole, who is chief of neurosurgery at the medical center, said Mrs. Giffords is still responding to commands to squeeze hands and move her toes.

Dr. Lemole said there are other good signs: “Not only are those centers of the brain working, but they’re communicating with one another.”

Of those injured in the deadly shooting Saturday in Tucson, eight are still hospitalized. Mrs. Giffords is in critical condition, five are in serious condition, and two are in good condition.

Recovering from a gunshot wound to the head depends on the bullet’s path, and while doctors are optimistic about Mrs. Giffords‘ odds, it can take weeks to months to tell the damage.

Doctors said the bullet traveled the length of the left side of the Arizona Democrat’s brain, entering the back of the skull and exiting the front.

Fortunately, it stayed on one side of her brain, not hitting the so-called “eloquent areas” in the brain’s center where such wounds almost always prove fatal.

Importantly, Mrs. Giffords was responding nonverbally Sunday to simple commands in the emergency room — things like “squeeze my hand.”

That implies “a very high level of functioning in the brain,” Dr. Lemole said.

Now, her biggest threat is brain swelling. Surgeons removed half of her skull to give the tissues room to expand without additional bruising, Dr. Lemole said.

That bone is being preserved and can be reimplanted once the swelling abates, a technique the military uses with war injuries, added his colleague Dr. Peter Rhee, who is a trauma surgeon.

Adding to Mrs. Giffords‘ good prospects is that paramedics got her to the operating room in 38 minutes, her doctors said. Now she is being kept in a medically induced coma, deep sedation that rests her brain. It requires a ventilator, meaning she cannot speak. Doctors periodically lift her sedation to do tests and said she continues to respond well to commands.

The brain’s left side does control speech abilities and the movement and sensation of the body’s right side, Dr. Lemole noted. But he wouldn’t speculate on lasting damage, saying, “We’ve seen the full gamut” in such trauma.

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