Gunshot Wound Traumatic Brain Injuries

With the nation’s focus on the tragic incident that happened to Congresswoman Giffords in Arizona, concern for her recovery has everyone interested in general about traumatic brain injuries caused by gunshot wounds.  Statistically, about 90% of individuals who are shot in the head die, but most die within the first couple of days.  Of those that survive, lasting deficits depend on the area or areas of the brain that were affected by the shooting.  One key treatment for survival of such a traumatic injury is to remove a portion of the skull to eliminate pressure on the brain from its swelling after the injury.  The swelling typically continues for about five days and is usually the worst on the third day after the injury.  A second treatment is to place the patient in a medically induced coma, which limits brain activity, so that the remaining brain cells can have a chance to repair themselves.  Patients are also put on a respirator to keep the brain cells bathed in oxygen, which is needed for cell recovery.

Once the initial survival hurdle is overcome, the patient is still at risk for seizures and infection, so medications are given early on to prevent both.   Severe brain injuries, such as from gunshot wounds, can leave the victim with physical disabilities, cognitive problems, and behavioral symptoms.  The potential physical symptoms can run from total or partial paralysis to things like vision and speech problems, and general fatigue.  Cognitive and behavioral disabilities from a severe brain injury can pose devastating problems for the victim too.  There are innumerable cognitive and behavioral issues that a TBI victim may have to deal with, including attention, concentration, learning, and memory issues, as well as depression, irritability, and inappropriate behavior issues.  Recovery from such a devastating injury is very slow, and improvements can continue to be seen months up to several years later.  Some of the recovery is attributable to rewiring of neurons in the brain, sprouting new connections to attempt to regain their former functions and take over functions of the neurons that were lost.

Rehabilitation usually starts at a Brain Injury Program at an Inpatient Rehabilitation Hospital and then progresses to outpatient programs and working with support groups.  Finally, one of the most important parts of the rehabilitation process is family understanding and support for the TBI victim.  Dealing with the effects of TBI is a lifelong issue for the family, as well as the victim.