Gabrielle Giffords and Cranial Gunshot Wounds Treatment

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by Dafé,

Gabrielle Giffords Shot

While many on the left will be quick to blame the right with contributing to 40-year old Arizona Democratic Congresswoman Gabrielle Giffords shooting, it is not immediately clear that the ‘tea party’ rhetoric and inflammatory speech led to the shooting that also killed a federal judge outside a supermarket and left five others dead, including a 9-year-old girl.

We all have to step back and realize that she is still in critical condition at the University Medical Center in Tucson, where Peter Rhee, trauma director said: “a single bullet had struck Giffords in the head and traveled through her brain.”

The motives behind the shooting are still not clear, but the suspect, 22-year-old Jared Lee Loughner, was said to have mental health issues.

Thomas Hollihan, who teaches classes on political rhetoric at USC, said people on the political fringe “get affected by a kind of toxic political culture that makes them angry and paranoid that their government is being taken away.”

Rep. Gabrielle Giffords is married to astronaut Mark E. Kelly, who has piloted space shuttles Endeavour and Discovery. The two met in China in 2003 while they were serving on a committee there, and were married in January 2007. Sen. Bill Nelson, chairman of the Senate Commerce Space and Science Subcommittee, said Kelly is training to be the next commander of the space shuttle mission slated for April. His brother is currently serving aboard the International Space Station, Nelson said.

Cranial Gunshot Wounds Diagnosis

If a patient’s blood pressure and oxygen level can be maintained upon arrival at the hospital, an urgent computed tomography (CT) scan of the brain is obtained.

Cranial Gunshot Wounds Treatment

Virtually all cranial gunshot victims are aggressively resuscitated upon initial arrival at the hospital.

The decision to proceed with surgery to manage the wound is based on three factors:

1. The level of consciousness as determined by the Glasgow Coma Scale (GCS)
2. The degree of brainstem neurological function
3. The findings on the CT scan

Death is virtually certain among comatose patients with minimal evidence of brainstem function and no evidence of an intracranial hematoma.

In such patients, aggressive treatment is rarely pursued because of the futility of the situation.
If, however, the CT scan identifies a hematoma, a craniotomy to open a section of skull and surgically remove the clot is generally warranted, and some of these patients will make a satisfactory recovery.

Cranial Gunshot Wounds Outcome

Recovery after brain injury varies widely.
The predictors of poor brain function outcome or death after a gunshot wound to the head include the initial GCS score, older age, presence of low blood pressure or inadequate blood oxygen shortly after injury, and dilated non-reactive pupils.
The bullet trajectory through the brain carries major significance. Bullets that cut through the brainstem, multiple lobes of the brain, or the chambers where spinal fluid is located are particularly lethal.
Many initial survivors develop uncontrollable pressure on the brain and subsequently die.

Comments

4 Comments so far

Bruce Alan | 09 January 2011, 00:58
As the father of a severe traumatic brain injury survivor and as one myself, I have literally spent months in neurosurgery ICU. The nurses who look after such patients are second to none, both as specialized health professionals and as people. Rep. Giffords survival will rest more in their hands than in her surgeons’ over the coming days. However ‘fortunate’ her lot is thusfar, her life will almost surely be forever changed.
Tree Stand Safety | Travel First Aid Kits | 10 January 2011, 21:55
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Best Hospitals - Brain Surgery at Johns Hopkins Video | MyDocHub – Health Blog & Health Tips Articles | 13 January 2011, 06:48
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Chuck | 20 January 2011, 11:24
It’s amazing what modern medicine can do. I heard she was up and walking in her hospital room yesterday!