



As doctors continue to monitor Rep. Gabrielle Giffords's condition, previous cases of brain injury resulting from bullets and other assaults can help explain what happens to the nervous system during major injuries--and how those rare recoveries are possible
By Katherine Harmon | January 11, 2011 | 6
When presidential candidate Sen. Robert F. Kennedy (D–N.Y.) was shot with a .22-caliber revolver in 1968, one of the bullets tore through his torso, another traveled from his armpit through the back of his neck, and a third entered his head behind his right ear....[More]
When presidential candidate Sen. Robert F. Kennedy (D–N.Y.) was shot with a .22-caliber revolver in 1968, one of the bullets tore through his torso, another traveled from his armpit through the back of his neck, and a third entered his head behind his right ear. This third bullet caused severe bleeding and swelling in the brain, putting pressure on the midbrain, which controls basic functions.
Even though doctors removed part of Kennedy's skull to relieve pressure, as they have done in the case of Rep. Giffords's case, brain swelling continued "so much so that the swelling became out of control and escaped the ability of the medical science at the time," says Marc Nuwer, critical care expert and neurologist at the University of California, Los Angeles, and member of the American Academy of Neurology.
[Less]
[Link to this slide]
A minority of people who suffer a gunshot wound to the head survive. A bullet that traveled through both brain hemispheres left President Ronald Reagan's press secretary James Brady partially disabled after a 1981 assassination attempt that also injured the president ....[More]
A minority of people who suffer a gunshot wound to the head survive. A bullet that traveled through both brain hemispheres left President Ronald Reagan's press secretary James Brady partially disabled after a 1981 assassination attempt that also injured the president.
Having entered through the left forehead, the bullet traveled through part of Brady's corpus callosum and into his right frontal lobe, according to news reports at the time. The bullet "appeared to go through his motor area and the areas that control speech," Nuwer explains. Brady's speech and movement were so impaired that the injury "basically was a career ender for him." The surgeons at the time had early indications that the wound would likely have dire consequences. "Mr. Brady had no movement on his left side and his right side moved only in response to the deepest pain," a New York Times article noted at the time.
[Less]
[Link to this slide]
In one of the most famous examples of penetrating brain injury, an explosion sent a metal rod through railroad-worker Phineas Gage's head. The rod, protruding from his left cheekbone and the top of his skull, passed through the brain's frontal lobes, which are responsible for personality among other advanced functions....[More]
In one of the most famous examples of penetrating brain injury, an explosion sent a metal rod through railroad-worker Phineas Gage's head. The rod, protruding from his left cheekbone and the top of his skull, passed through the brain's frontal lobes, which are responsible for personality among other advanced functions.
Although Gage survived the traumatic injury and retained reasoning capabilities, the damage to his brain changed his personality. Once a tolerant overseer, after the injury he became "fitful, irreverent, indulging at times in the grossest profanity (which was not previously his custom)," his doctor J. M. Harlow wrote in a 1868 report in the Bulletin of the Massachusetts Medical Society. "His mind was radically changed—so decidedly that his friends and acquaintances said he was 'no longer Gage.'"
[Less]
[Link to this slide]
Bullets do not have to enter the brain to do lasting neurological damage. In 1972 presidential hopeful and Alabama Governor George Wallace was shot several times with a .38-caliber gun at a distance of slightly less than half a meter....[More]
Bullets do not have to enter the brain to do lasting neurological damage. In 1972 presidential hopeful and Alabama Governor George Wallace was shot several times with a .38-caliber gun at a distance of slightly less than half a meter. One of the bullets, which entered near his waist, was lodged in the spinal canal, the hole in the spinal column through which the nerve bundles pass.
"The very impact of the bullet probably bruised the delicate nerve tissue severely," according to an article written at the time. The severed nerves meant that "Wallace reported no feeling in his legs," the report noted; had the bullet landed higher up in the vertebral column, he likely would have lost more motor function. As it was, he needed a wheelchair to get around afterward but was able to return to work as governor.
[Less]
[Link to this slide]
If a bullet does not pass all the way through the head at the time of the shooting, doctors will often try to remove it surgically to reduce the risk of infection....[More]
If a bullet does not pass all the way through the head at the time of the shooting, doctors will often try to remove it surgically to reduce the risk of infection. But if the projectile is lodged too deeply or in too sensitive a brain area, occasionally, it will be left in. "You don't actually have to take the metal out of the head," Nuwer says.
Patrick Ireland was shot once in the foot and twice on the left side of the head during the 1999 shootings at Columbine High School in Littleton, Colo. One of the bullets "penetrated his brain and traveled eight inches to the back of his skull," a 1999 news report noted. Although Ireland was still suffering from speech problems and partial paralysis on his right side in the months after the shooting, as of two years ago at the age of 27, he had only a slight limp.
[Less]
[Link to this slide]
Perhaps the vast majority of brain injuries happen not from penetration, such as a gunshot wound, but are so-called closed-head injuries that occur when the brain is assaulted by outside force—whether that is from a car crash or a nearby explosion....[More]
Perhaps the vast majority of brain injuries happen not from penetration, such as a gunshot wound, but are so-called closed-head injuries that occur when the brain is assaulted by outside force—whether that is from a car crash or a nearby explosion.
Common concussions, such as those often sustained in football, are minor closed-head injuries and can cause confusion, headaches and memory loss, most of which usually disappear with time (although repeated assaults of this magnitude can have a cumulative effect on cognitive functioning).
Major closed-head brain injury, such as that sustained by ABC reporter Bob Woodruff in Iraq when the convoy he was traveling in struck an improvised explosive device in 2006, can have lasting, if not fatal consequences. At this level of injury, "you start to see much more pronounced swelling" and the brain becomes less adept at moving protein and calcium, which are crucial to its chemical balance, Nuwer explains. After Woodruff's injury, doctors put him into a medically induced coma for 36 days. Woodruff returned to work a little more than a year after his injury, but even then he still occasionally had difficulty with words, according to ABC.
[Less]
[Link to this slide]
YES! Send me a free issue of Scientific American with no obligation to continue the subscription. If I like it, I will be billed for the one-year subscription.
The Brain's Own Marijuana
The Will to Power--Is "Free Will" All in Your Head?
YES! Send me a free issue of Scientific American with no obligation to continue the subscription. If I like it, I will be billed for the one-year subscription.
6 Comments
Add CommentMy brain injury stemmed from my heart stopping for 10 minutes during the suturing of a gash to my forehead under general anesthesia following a car accident, leaving me without ALL that we learn as infants - how to walk, speak, play tennis, remember, etc. I was able to get 95% of all that back by staggering, walking and jogging the 3.6 miles home from work 92 times (= 330+ miles) within a year of the cardiac arrest, and went on to become a professor at one of the premier design schools in the world, the Swiss campus of Pasadena's Art Center College of Design.
Reply | Report Abuse | Link to thisI am currently working on the design of a 100% sustainable world of the future, visible on my website at www.greenmillennium.eu In fact, it was the beginnings of these designs that occurred to me as I recovered, and pulled me forward, such was my desire to see the eternal components of our genes, in the form of our children's children's children's children's children's ...children benefit from this planet's first 100% sustainable and eternal infrastructure! So, the generation of altruistic goals can also provide a powerful incentive for many victims of similar situations to pull themselves into better, if not fully recovered, situations!!!
Please visit the website, and try it yourself!
This politician took a bullet for her constituents. Its really doubtful anyone else in Congress would be so dedicated to their work. This woman should be granted lifetime tenure in politics for her district as reward for her clearly evident loyalty to the voter. She will provide a most vivid object lesson to anyone in Congress as she walks the aisle to cast a vote bearing PROUDLY the medal of honor on her forehead for all to see. God Bless Gillford and God have mercy on America to have come to THIS...
Reply | Report Abuse | Link to thisThere is much that is new in our understanding of the brain; with this is added knowledge of how to have positive influence on brain self-regulation through neurofeedback procedures. This is a growing field of treatment.
Reply | Report Abuse | Link to thisSorry, Didonai, But nobody should get tenure for being a victim of such a tradgedy. In fact, we should impose term limits on all politicians. Its the carrer politicians who find what a greatg gig they have, that they do anything to stay there even if it means abandoning our representation for there own selfish interests... Serving our country as a career politician, is not what our fore-fathers (sp) had in mind.
Reply | Report Abuse | Link to thisNo. You need look no farther than California if you want to see what term limits does. Who wants to sign up for a job that they can only have for 8 years that costs millions to get? Answer? Idealists and people with no better options for the most part. Neither are good for politics.
Reply | Report Abuse | Link to thisIt takes 4-6 years to learn the job. So in California we get 2 years of real work out of our elected officials.
But the worst thing is that term limits make politicians more corrupt, more malleable to money influencing their vote. The reason is simple. They have nothing to lose! Since they know they are getting kicked out of office anyway, no matter how good a job they do, why should they care? So they do the predictable. They work to feather their nest after they are out of office, and cut more shady deals than ever.
It's not complicated, in fact this is all blindingly obvious. The "regular folks" who have the idea that term limits are good never put themselves in the shoes of the politicians they elect.
Ask yourself this, and answer honestly: If I were hired for a job, keeping it required prostituting myself to special interests in order to raise money to buy my way in, nobody really paid attention to how I did my job, and no matter how well I did my job, I would be fired at 4 years or at 8 years for sure, what would you do?
Really, truly, seriously, what would you do?
John, why did Californian's vote for term limits?
Reply | Report Abuse | Link to thisBecause the other option was not working either.
The problem isn't how long someone stays in office, it's a system that breed corruption and politicians representing special interest instead of those that elected them.
It's the system that needs to be changed.