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Video: Neurosurgeon: Giffords ‘holding her own’

Image: JoNel Aleccia
By JoNel Aleccia Health writer
msnbc.com
updated 1/10/2011 12:33:46 PM ET 2011-01-10T17:33:46

Arizona Rep. Gabrielle Giffords is "holding her own" and continues to respond to simple commands, Dr. G. Michael Lemole Jr., the chief of neurosurgery at University Medical Center in Tucson said Monday.

"I just came from Congresswoman Giffords' bedside and I'm happy to say she's holding her own," Lemole, who operated on Giffords after a bullet tore through the left side of her brain, told TODAY Monday. "And that is to say that she's doing the same things she was yesterday.  And that's the most we can hope for at this time."

Associated Press

Giffords is in a medically induced coma but is responding to verbal commands — raising a thumb, showing two fingers or wiggling toes — two days after she was shot at point-blank range at a public gathering in a supermarket parking lot in Tucson, Ariz.

Tests indicate that the swelling in her brain has not increased, Lemole told reporters at a news conference Monday. Peak swelling typically occurs within three to five days of a traumatic brain injury.

"At this phase in the game, no change is good and we have no change," Lemole said.

Doctors were forced to remove part of Giffords' skull to reduce swelling after the bullet traveled — back to front — the entire length of the left side of her brain.

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Giffords could remain in the ICU for a week or "maybe more," Lemole said.

Doctors continue to assess Giffords' condition several times a day through CT scans and verbal tests. Giffords will remain on a ventilator until perhaps the end of the week, and that device has prevented her from speaking. Lemole said it wasn't clear whether Giffords recognized family members.

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Even after leaving intensive care, the congresswoman likely faces a long and uncertain recovery, a head injury expert said Sunday.

"She's still critically ill," said Dr. Alex Valadka, a neurosurgeon and spokesman for the American Association of Neurological Surgeons. "We get excited when people hold up a couple of fingers, but that's a long way from higher functioning."

On Monday, Lemole didn't speculate about her chances for recovery or whether Giffords would regain her speech after being removed from the breathing tube.

"I've seen the full gamut possible — from functional recovery to limited recovery," he said.

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People who suffer penetrating traumatic brain injuries often develop paralysis and cognitive problems. The left side of the brain is typically responsible for speech and controls the right side of the body, Valadka explained, noting that most people are right-handed.

Giffords was fortunate that the bullet did not cross the geometric center of the brain, Lemole said earlier. Early reports indicated she might have been shot in one temple with the bullet exiting the other, but Lemole said the single shot entered in the back and exited the front.

She also was fortunate that paramedics rushed her to the level-1 trauma center in Tucson, getting her into surgery within 38 minutes, doctors said.

With skilled surgery and access to early and comprehensive cognitive rehabilitation, some patients are able to make remarkable recoveries, noted Dr. Gregory O'Shanick, chairman and past medical director of the Brain Injury Association of America based in Vienna, Va.

He pointed to public examples such as ABC news anchor Bob Woodruff, who suffered a brain injury in 2006 in Iraq, and has since recovered enough to go back to work. And he noted that James Brady, President Ronald Reagan's press secretary, who was shot in the head in a 1981 attempt on Reagan's life, was able to regain many of his former functions.

About 1.7 million people in the United States suffer traumatic brain injuries every year, with about 20 percent of them caused by violence, including gunshots. About 52,000 people die as a result of their injuries and about 275,000 are hospitalized, according to the Centers for Disease Control and Prevention. Of the deaths caused by traumatic brain injury, perhaps 35 percent to 40 percent are attributed to gunshots.

Victims such as Gifford receive expert treatment because many trauma surgeons have learned from the battlefield lessons of Vietnam, Iraq and Afghanistan, O'Shanick said. Access to comprehensive, sustained cognitive rehabilitation therapy is the key, he added.

Much attention will be focused in the early weeks on Giffords, like other victims of penetrating traumatic brain injury, Valadka said. But the real work of recovery lasts much longer.

"Neurological time is measured in months and years," he said.

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Photos: Mourning follows deadly shooting in Arizona

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  1. A hearse carrying the remains of U.S. District Judge John Roll arrives at the St. Elizabeth Ann Seton Church before his funeral on in Tucson, Ariz., Friday, Jan. 14. Roll was killed in the Jan. 8 shooting that left six dead and wounded 13, including U.S. Rep. Gabrielle Giffords. (Morry Gash / AP) Back to slideshow navigation
  2. Mary Kool holds a single red rose outside the St. Elizabeth Ann Seton Church where the funeral of U.S. District Judge John Roll was to take place. (Eric Thayer / Reuters) Back to slideshow navigation
  3. Mourners arrive at the funeral service of Judge Roll. (Kevork Djansezian / Getty Images) Back to slideshow navigation
  4. A flag recovered from ground zero is raised during funeral service for 9-year-old Christina Taylor Green at the St. Elizabeth Ann Seton Church in Tucson, on Thursday, Jan. 13. Green was the youngest victim of the shooting rampage. Green was born on Sept. 11, 2001. (Mamta Popat / EPA) Back to slideshow navigation
  5. Left to right, Roxanna and John Green, mother and father of Christina Taylor Green, and their son Dallas Green, arrive at St. Elizabeth Ann Seton Church for her funeral in Tucson on Thursday. (Mamta Popat / Pool via Reuters) Back to slideshow navigation
  6. 2,000 mourners were in attendance at the funeral of Christina Taylor Green on Thursday in Tucson. (Mamta Popat  / Pool via EPA) Back to slideshow navigation
  7. People dressed as angels line the street leading to the St. Elizabeth Ann Seton Church where the funeral for Christina Taylor Green was to take place in Tucson on Thursday. Hundreds, dressed in white, lined the streets for more than a quarter mile of the funeral procession. (Mike Segar / Reuters) Back to slideshow navigation
  8. John Green kisses his son Dallas on the head as the family follows the casket of Christina Taylor Green at her funeral mass in Tucson, on Thursday. At left is Christina's mother Roxanna and at right is Camden Grant, Christina's godmother's son. (Rick Wilking / Pool via AP) Back to slideshow navigation
  9. A young mourner carries flowers and a teddy bear to the funeral of Christina Taylor Green in Tucson on Thursday. (Mamta Popat / Pool via EPA) Back to slideshow navigation
  10. Cindy and John McCain listen during the funeral service for shooting victim Christina Taylor Green in Tucson on Thursday. (Greg Bryan / Pool via Reuters) Back to slideshow navigation
  11. A woman holds the service program from the funeral for 9-year-old Christina Taylor Green outside St. Elizabeth Ann Seton Church in Tucson on Thursday. (Mike Segar / Reuters) Back to slideshow navigation
  12. President Barack Obama speaks at the University of Arizona's McKale Memorial Center during the memorial service for victims of the shootings in Tucson. Obama told the crowd on Wednesday, Jan. 12, that Rep. Gabrielle Giffords had opened her eyes for the first time since being shot in the head during the attack on Jan. 8. Six people were killed and 13 wounded by the lone gunman. (Jewel Samad / AFP - Getty Images) Back to slideshow navigation
  13. Daniel Hernandez , the 20-year-old intern credited with likely saving the life of Rep. Gabrielle Giffords, hugs her husband, NASA shuttle commander Mark Kelly, as U.S. first lady Michelle Obama applauds. (Jim Young / Reuters) Back to slideshow navigation
  14. First lady Michelle Obama holds the hand of Rep. Gabrielle Gifford's husband, NASA shuttle commander Mark Kelly, as they listen to President Barack Obama speak. (Jim Young / Reuters) Back to slideshow navigation
  15. People sing the national anthem during the memorial service on the University of Arizona campus in Tucson. (Chris Carlson / AP) Back to slideshow navigation
  16. President Barack Obama and first lady Michelle Obama at the start of the memorial event. (Jewel Samad / AFP - Getty Images) Back to slideshow navigation
  17. People line up at the University of Arizona campus for the memorial service. (David Becker / Getty Images) Back to slideshow navigation
  18. Barb Tuttle is overcome with emotion at a makeshift memorial outside the office of Rep. Gabrielle Giffords on Jan. 12 in Tucson. (Kevork Djansezian / Getty Images) Back to slideshow navigation
  19. Women waiting in line for the memorial service look at the campus paper at the University of Arizona. (Rick Wilking / Reuters) Back to slideshow navigation
  20. Mark Kelly, husband of Rep. Gabrielle Giffords, holds his wife's hand in the congresswoman's hospital room at University Medical Center on Jan. 9. (Offiice Of Gabrielle Giffords / Getty Images) Back to slideshow navigation
  21. Ron Barber, 65, district director for Rep. Gabrielle Giffords, is visited by Giffords aide Daniel Hernandez in his hospital room on Jan. 9. Hernandez rushed to Gifford's aid after she was shot. Hernandez said that while he held the wounded Giffords, he asked another bystander to put pressure on Barber's wounds. He also asked Barber for his wife's phone number and then shouted it out to someone so that Barber's wife, Nancy, could be informed of the shooting. (Gabrielle Giffords' Office / Reuters) Back to slideshow navigation
  22. President Barack Obama and First Lady Michelle Obama observe a moment of silence with White House staff members on the South Lawn of the White House in Washington on Jan. 10. (Jewel Samad / AFP - Getty Images) Back to slideshow navigation
  23. Congressional staff observe a moment of silence to honor victims of the assassination attempt on Rep. Gabrielle Giffords on the steps of the Capitol in Washington. (Michael Reynolds / EPA) Back to slideshow navigation
  24. Rachel Cooper-Blackmore, 9, adds a note to a memorial at Mesa Verde Elementary School in Tucson, on Jan. 10. Christina Taylor Green, 9, was killed during the Tucson attack. (Chris Carlson / AP) Back to slideshow navigation
  25. Rachel Crabb, 5, holds hands with teachers, parents and other students during a moment of silence for her slain schoolmate, Christina Taylor Green, at Mesa Verde Elementary School on Jan. 9. (John Moore / Getty Images) Back to slideshow navigation
  26. Candles are lit on Sunday at a makeshift memorial outside University Medical Center in Tuscon, Ariz., for those killed or wounded during the attack on Rep. Gabrielle Giffords . (John Moore / Getty Images) Back to slideshow navigation
  27. Ellie Steve, 6, from left, Lucia Reeves, 6, and Zoe Reeves, 18, gather for a candlelight vigil outside the office of Rep. Gabrielle Giffords in Tucson, Ariz., on Sunday. (Chris Carlson / AP) Back to slideshow navigation
  28. Six balloons representing the six people killed in Saturday's shooting spree, as part of a prayer vigil.Rep. Gabrielle Giffords battled for her life on Sunday after an assailant shot her in the head and killed six others in a rampage that has launched a debate about extreme political rhetoric in America. (Eric Thayer / Reuters) Back to slideshow navigation
  29. People console each other at a makeshift memorial located outside the University Medical Center on Jan. 9 in Tucson, Ariz. (John Moore / Getty Images) Back to slideshow navigation
  30. The American flag flies at half-staff on the U.S. Capitol in Washington, on Jan. 9. In a brief statement Sunday morning, House Speaker John Boehner said flags on the House side of the Capitol in Washington will be flown at half-staff to honor the slain aide, Gabe Zimmerman, of Rep. Gabrielle Giffords. Thirty-year-old Zimmerman was among six killed Saturday. (Manuel Balce Ceneta / AP) Back to slideshow navigation
  31. The congregation prays for the victims of Saturday's shooting in Tuscon, at the Pantano Christian Church in East Tucson, Jan. 9. (Rick Wilking / Reuters) Back to slideshow navigation
  32. Monty Edmonds, 36, left, of Tucson; Maggie Kipling, 34, of Tucson; Leigh Harris, 50, of Phoenix; Bella Furr, 21, of Tucson; and Sarah Herrmann, 22, of Tucson participate in a vigil at University Medical Center for Rep. Gabrielle Giffords, who was shot during an event in front of a Safeway grocery store Jan. 8, in Tucson, Ariz. (Laura Segall / Getty Images) Back to slideshow navigation
  33. Emergency personnel use a stretcher to move Rep. Gabrielle Giffords after she was shot in the head outside a shopping center in Tucson on Saturday. (James Palka / AP) Back to slideshow navigation
  34. Ernie Freuler fights back tears as Ray Lilley takes photos of the scene outside the office of Rep. Gabrielle Giffords after she was shot in the head by a gunman who opened fire outside a grocery store, Saturday, Jan. 8, in Tucson, Ariz. (Chris Morrison / AP) Back to slideshow navigation
  35. A law enforcement officer stands outside the home of Jared L. Loughner, identified by federal officials as the suspect arrested in connection with the shooting of U.S Representative Rep. Gabrielle Giffords in Tucson, Ariz., Jan. 8. (Eric Thayer / Reuters) Back to slideshow navigation
  36. People gather for a candlelight vigil for the victims of the shooting in Arizona at the steps of Capitol Hill in Washington, D.C., on Saturday Jan. 8. (Jose Luis Magana / AP) Back to slideshow navigation
  37. Vera Rapcsak and others hold signs outside the office of Rep. Gabrielle Giffords on Saturday after she was shot while meeting constituents. (Chris Morrison / AP) Back to slideshow navigation
  38. Emergency personnel attend to a shooting victim outside a shopping center in Tucson, Ariz. on Saturday, Jan. 8, where Rep. Gabrielle Giffords and others were shot as the congresswoman was meeting with constituents. Rep. Giffords, 40, a Democrat, took office in January 2007, emphasizing issues such as immigration reform, embryonic stem-cell research, alternative energy sources and a higher minimum wage. The gunman shot Giffords in the head, seriously wounding her, and killed six other people in a shooting rampage at a public meeting in Tucson on Saturday. Giffords was airlifted to a hospital in Tucson where she underwent surgery. One of the doctors who treated her said he was optimistic about her recovery. (James Palka / AP) Back to slideshow navigation
  39. A woman places flowers by the office of Rep. Gabrielle Giffords on Capitol Hill in Washington on Saturday after she was shot in Tucson by a gunman who opened fire, killing six people, including a U.S. district judge, John M. Roll. (Nicholas Kamm / AFP - Getty Images) Back to slideshow navigation
  40. In this photo provided by The White House, President Barack Obama talks with Arizona Gov. Jan Brewer about the shooting. (Pete Souza / AP) Back to slideshow navigation
  41. Emergency personnel at the scene where Giffords and others were shot outside a Safeway grocery store in Tucson on Saturday. (Matt York / AP) Back to slideshow navigation
  42. Law enforcement personnel work the crime scene on Saturday. (Eric Thayer / Reuters) Back to slideshow navigation
  43. A medical helicopter evacuates victims from the shooting scene. (Reuters) Back to slideshow navigation
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  1. Image:
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    Above: Slideshow (45) Mourning follows deadly shooting in Arizona
  2. Image: US Senate holds hearing on Gun Control
    Jim Lo Scalzo / EPA
    Slideshow (26) Former Ariz. Rep. Gabrielle Giffords

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