skull is missing. this was i don t know how much of that was taken out for the expansion of her brain, the swelling and how much she lost in the shooting. what would she look like with that section of her skull missing and what are some of the risks involved? yeah. that operation called a craniectomy basically is as you say, to try to control swelling at the time of the injury. let me show you quickly if i can, i don t know how well you can see this, this is a skull and this is sort of what a craniectomy would look like. i did this on a model yesterday to show you guys. about the size of my palm roughly. that s, again, so that brain when the brain swells, it has no place to swell because of the rigid casing. you give it some room here. as a result to your question, you get some concavity on that side of the head, left side of the head, for example. that would be noticeable because you just don t have that normal contour here of the head. as you know, that s going to be put back a
from what we re hearing and from what the doctors have been saying, she s been doing very well in that regard, clearly showing good high cognitive function, moving both sides of her body well. we heard reports of that today. not weak on one side of the body versus the other. i should point out, as well, t.j., one of the biggest concerns is swelling of the brain. that will need to be monitored for a few days, serm, maybe even longer than that. doctors have sort of anticipated that during the operation, not only did they remove bone fragments from where you bullet went in, but they also tack utah more bone on the left side of her head so as to allow the brain into swell into that area. if the brain swells, t.j., because of the hard skull, it has nowhere to go and that can be a catastrophic situation. doctors providing extra room by performing this operation called a cranioectomy.
this so far has been a very good situation. hopefully, it will stay that way. obviously, we don t know which direction she s going to go. it s still very precarious at this time. did she have a cat scan, and if so, what did that show? we always do cat scans. in fact, we had a cat scan before the first surgery. that tells us as surgeons where we have to focus our efforts. i can t go into the details for obvious patient privacy issues, but it showed the track of the bullet through the left hemisphere. it implied that it was not through some of those critical trajectories that would have made recovery much, much more difficult. when you talk about milestones, what happens when the brain swells? so normally in the icu stage, when the brain swells, it s like your knee, when you sprain your knee and fluid accumulates in there. it gets very tense and a tremendous amount of pain. in a brain, it will go through that same situation, except when it gets real tense in there, the blood flow
bones and doctors removed more bones to relieve pressure from inside of the skull where the brain swells. also remaining are bone fragments and bullet fragments. because of that and any number of other factors there is always the risk that the brain will swell additionally. that is why the doctors have to say they are cautiously optimistic she can recover. bret: we willle head back for any breaking details, thank you. capitol lawmakers continue to express sadness over the shooting of their colleague. joining me with his expression of yesterday s events and a look forward, republican representative jason from utah. thanks for being with us on this tough day. it is a tough day. it is the whole spectrum, bret. we have heros out there that stepped up and when they woke up in the morning they didn t know it was going to happen and then you have the sadness and anguish of that 9-year-old girl. she touches all of our hearts.
very important. and you and i have talking about this early, but the idea that the brain is likely to swell in response to this injury. if you have swelling in many organs in your body, such as in your abdomen, there s plenty of room for it to swell. in the brain, you don t, because of the hard skull. so the objective and what the doctors are describing there is to remove a lot of other bone on that side of the injury, on the left side, and essentially leave that bone off for the time being. and in that situation, if the brain swells, it s not going to be confined by the skull and it has room to swell. when the brain starts to heal and the swelling goes down, that bone can subsequently be placed back. sanjay, they were reluctant to give timetables, which i get, because medicine is a science and not an exact one, as you know better than any of us sitting here, but is there a danger period that you can pass, for instance, with the brain swelling? if you don t see more brain swelling fo