Doctor: Giffords likely shot in front of head, not back

NEW YORK — Doctors now think that Rep. Gabrielle Giffords may have been shot in the front of the head, not the back.

After she was wounded last weekend, doctors said the bullet traveled the length of the left side of the congresswoman's brain, entering the back of the skull and exiting the front.

At a briefing Tuesday, Dr. Peter Rhee said it now looks like she was probably shot in the front, with the bullet going out the back, although they can't say for certain.

He said that's based on consultations with two specialists who came to Tucson, Ariz.

Also, Giffords is breathing on her own, said Dr. Michael Lemole, the chief of neurosurgery at University Medical Center in Tucson.

Lemole said at a news conference that the congresswoman is still following simple commands, although she remains on a breathing tube to protect against complications such as pneumonia. She's alert and responding to doctors.

Earlier Tuesday Lemole told TODAY there were no significant changes in her condition overnight. "As frustrating as that may sound, that's a good thing," Lemole said.

When asked about swelling in her brain on the third day, Lemole said a CAT scan early Tuesday showed no increase in swelling, although he cautioned that it can sometimes take longer for the condition to peak. Nearly half of Giffords' skull was removed to alleviate any swelling.

She has given a thumbs-up sign and tried to grab at the breathing tube, an encouraging sign of the level of consciousness and her reaction to pain.

"The fact that she's able to register that discomfort and then react to it, again, it means the brain is working on a higher level," Lemole said.

Without speculating on the congresswoman's long-term prognosis, Lemole said she has the "full range" of recovery ahead of her.

"I've seen people in this scenario make very little improvement and require constant care, and I've seen other people ... who have made remarkable recoveries -- functional recoveries -- and gone back to work," Lemole said. People who suffer penetrating traumatic brain injuries often develop paralysis and cognitive problems.

Usually with a penetrating injury through the skull, survival and recovery is "abysmal," said Lemole at the news conference. "She has no right to look this good."

Giffords is expected to remain in the ICU for at least another week.

Giffords, a three-term Democrat, was shot at point-blank range on Saturday at a public gathering in a supermarket parking lot in Tucson, Ariz. The shooting rampage claimed the lives of six people, including a congressional aide and a nine-year-old girl. Fourteen people were wounded or injured. Two people were discharged Sunday night. Six victims remain hospitalized. Lemole said the other patients are doing "very well." Three of the shooting victims remain in serious condition, two are in fair condition. Only Giffords remains in critical condition.

About 1.7 million people in the United States suffer traumatic brain injuries every year, with about 20 percent of them caused by violence, including gunshots. About 52,000 people die as a result of their injuries and about 275,000 are hospitalized, according to the Centers for Disease Control and Prevention. Of the deaths caused by traumatic brain injury, perhaps 35 percent to 40 percent are attributed to gunshots.