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April 27th, 2011
01:02 PM ET

Gupta on Giffords' missing piece of skull

Dr. Sanjay Gupta details the extraordinary efforts to save the life of Rep. Gabrielle Giffords in a CNN special documentary, "Saving Gabby." Sunday, May 8, 7 p.m. ET

The final preparations are under way for Friday's last-ever launch of the space shuttle Endeavour. This mission is extra special for Commander Mark Kelly. His wife, Arizona Rep. Gabrielle Giffords, who has been recovering from a gunshot wound to the head since January 8,  was medically cleared to travel and left Wednesday for Florida and the Kennedy Space Center, to watch the launch.   CNN's Chief Medical Correspondent, Dr. Sanjay Gupta has been following Giffords' progress and takes us inside his operating room to show how the congresswoman's surgeons  removed part of her skull in an effort to save her life.

Why is a piece of  Giffords' skull missing?

After surviving a gunshot wound to the head, Giffords had hemi-craniectomy surgery. Surgeons removed almost half of her skull  to allow room for her brain to swell. When a traumatic injury causes the brain to swell, it has no place to expand because of the rigid casing of the skullbone. Performing a craniectomy gives it some room. The section of her skull that was removed on January 8 is being preserved in a freezer. It's common for brain injury patients to continue medical care and rehab without replacing the bone. A follow-up operation to restore the skull generally happens in three to six months.

Is it medically safe to travel?

Doctor's have said it's safe for Giffords to travel.  She does not need to be medically escorted on the flight. When a portion of the skull is missing beneath the scalp, it's  common for a person to wear a protective helmet. Even without the bone,  a thick layer of skin covers the area, so risk of infection is low.

What would she look like with the piece of skull still missing?

Because of the location and size of the bone removed, she would have a concave  area on the left side of her head. Giffords' neurosurgeon, Dr. Michael Lemole, says the area of the head that is typically curved, rounded out, would be sunken in.

When will she have surgery to replace the missing part of her skull?

When Giffords' bone flap was removed, it was placed in a freezer - standard procedure. But now,  her doctor believe that the bone may be contaminated by germs from the bullet. Because of this, they will not replace the missing piece with her original bone. Instead they will replace her skull with a cranial implant. The surgery is scheduled for next month.



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Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.