"When the brain swells, the skull, which usually protects the brain, becomes your worst enemy," he explained.
Replacement surgery isn't done until the swelling stops and the brain has shrunk back to its normal size, Cohen added.
The replacement piece would probably be a custom-made plastic implant that fits the opening perfectly, said Dr. Ricky Madhok, a neurosurgeon at North Shore University Hospital in Manhasset, N.Y., and Nassau University Medical Center in East Meadow, N.Y. It is meant to protect the brain and give her head a natural appearance, he noted.
"To replace the part of the skull, certain types of plastic can be used to recreate the skull," explained Madhok, who was not involved in Giffords' surgery. "Keep in mind, the purpose of the skull is to provide a protective barrier to the brain, whether that is done by bone or by a specially designed plastic."
The technology for these replacement implants is now very advanced, he added. "One of the biggest things to be developed in this area is custom designed implants," Madhok said. "As such, using finely cut CT scans, each implant can be made to fit and recreate the skull in such a way that the overall fit is as if the original bone itself was replaced."
"Within a week, you get a ready-made prosthetic that exactly matches the defect," Cohen added.
"As soon as you close the scalp, the patient looks symmetrical again. The cosmetic result is very striking right from the get-go," Cohen said. "They look like themselves again right away."
For more on head injuries, visit the U.S. National Library of Medicine.
SOURCES: Anders Cohen, M.D., chief, neurosurgery, The Bro
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