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Luck Under Fire

January 14, 2011

Rheanna Sand

 

Congresswoman Gabrielle Giffords of Arizona was shot in the head on Saturday, January 8th while talking to her constituents outside a local Safeway. Six people, including a 9-year-old girl born on 9-11, were killed in the attack. Despite having her skull pierced by a single 9mm round, five days later Representative Giffords was able to move her limbs and recognize loved ones. Although still in critical condition, the question remains: how did this woman survive a wound that nearly 90% of victims die from?

There were a few key factors. Luckily - if I can use that word in such a tragedy - the bullet took a clean path through Ms. Giffords' head and didn't explode or ricochet. The path was also limited to the left side of her brain, which is fortunate, but it is also happens to be the dominant hemisphere responsible for vision, speech, and linear reasoning. Apparently the bullet passed directly above the visual cortex, sparing this most crucial area, but it remains to be seen how other areas are affected. People with left-side brain injuries can have trouble reading, speaking, and show impulsivity or a lack of long-term planning.

The rapid response of medical teams were also critical in Ms. Giffords' survival. If a patient lives through an initial gunshot, brain swelling is the next deadliest enemy. Wounds emits chemical signals, like histidine, which lead to an inflammatory response. Since the skull is a fixed enclosure, swelling puts pressure on the blood vessels of the brain, eventually cutting off supply. When brain cells are deprived of oxygen, like any other cell in your body, they die.

So, in the frenzy of emergency surgery, Rep. Giffords' doctors performed a decompressive hemicraniotomy - the medical term for giving the brain some breathing room. They surgically removed a large portion of her skull, a radical procedure that has become commonplace in such injuries, as it provides a quick, mechanical way to ease blood flow. And if it weren't for the simplicity of that procedure, and the lucky path of that fateful bullet, the U.S. would be mourning one more human that didn't need to die.

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