The seemingly miraculous recovery of function by Rep. Gabrielle Giffords
was a reason for cheer following the assassination attempt that took the
lives of six others last year.
The Arizona Congresswoman had sustained a terrible gunshot wound to
her head. Yet today, she is walking and talking, and was greeted by enthusiastic
applause from colleagues at President Obama’s State of the Union
address in January.
What causes such remarkable recoveries as Giffords’? Why do some
patients with severe brain injuries recover amazingly well, while others do not?
Ricardo Komotar, M.D. University of Miami, specializes in neurosurgery.
“It’s mainly the initial insult,” he says. “How severe is the initial insult and
what part of the brain got injured?”
With some other injuries, getting early treatment, intensive rehabilitation
and other interventions can change the final outcomes — but Komotar says
that’s not the case with brain injuries.
“Getting early treatment is not really what makes the difference,” he
explains. “How the patient is going to do is determined day one.
“You can never predict for sure, (but) when you see enough head injury,
you have an idea of what the outcome is going to be. So depending on the
severity of the head injury, depending on the time in which you’re talking to
the family, you can give them a general prognosis. Sometimes you know that
an injury is fatal. Other times, you know the chance of functional recovery
is slim, and so you make your best guess early on, but you always tell them
there’s a chance for recovery later on.”
But do some patients’ recoveries still surprise their doctors?
“Absolutely,” Komotar says. “Every person’s different. You can go by the
numbers, but the numbers are only part of it, and every person’s different, so
it’s very difficult to predict just based off of percentages.”