News reports over the past week or so have covered the remarkable progress of Congresswoman Giffords as she makes strides towards recovery from a brain injury sustained in a shooting rampage in Arizona. A car accident law firm in Louisiana knows that brain injuries can arise in any incident that causes trauma to the head. Car accidents, sports injuries, slip and falls injuries and, indeed, injuries from firearms can all lead to traumatic brain injury.
As the Congresswoman starts her journey to recovery, experts do not yet know the total extent of the damage caused when the bullet pierced her skull. The tragic incident sparked many debates across the country, some political, some not. One debate that has surfaced includes a radical surgery for patients with brain injuries.
The procedure, called decompressive craniectomy, is not a new concept. The procedure was first introduced in the early 1900s, however, doctors shied away from using the procedure in the 1990s due to the extreme risks associated with the surgery. The procedure is still used in specific cases by civilian and military doctors
A small section of the skull is removed from the patient to relieve pressure in the skull. Geoffrey Manley, chief of neurosurgery at San Francisco General Hospital, says when the procedure is “applied appropriately, it absolutely works.” Swelling inside the skull occurs in many brain injury cases. The closed cavity in the skull allows pressure to build. Brain structures, including the brain stem can be crushed from the increase in pressure. The procedure allows an avenue to ease the pressure and allow the brain to heal after trauma.
Medical experts, including Manley, acknowledge that the procedure has not had adequate testing. However, studies are underway regarding the procedure to determine which head trauma injury patients will receive the most benefit from its use. Manley says that the surgery “is being applied too widely today.” Sometimes head trauma will cause the brain to twist inside the skull. There may not be swelling associated with that type of brain injury.
Five years ago an ABC news correspondent was injured by a roadside bomb in Iraq. The correspondent was placed in a coma and he received a craniectomy. The correspondent has to wear a helmet and was not allowed to roll over in bed after the procedure.
Eventually, the correspondent healed sufficiently for doctors to repair the man’s skull. Doctors patched the open area of the correspondent’s skull with a synthetic prosthesis. The correspondent says that the original section of skull that had been removed “did not survive.”
Doctors can make a synthetic prosthesis that matches exactly through the use of CT scans of the patient’s head. Dr. Shelly Timmons, director of neurotrauma at the Geisinger Health System in Danville, Pennsylvania, says occasionally doctors can freeze the portion of removed skull and implant it in the patient’s abdomen in order to keep the skull fragment alive and protect it from infection.