Just wanted to add a bit about her surgery and the replacement of her skull.
If the brain is swelling, and has no "outlet" near the injury site, the brain be pushed downward through the place where the neck connects. If that happens, the part of our brain that controls things like breathing and all the "auto" things will be ruptured, and most likely death will follow.
The skull is removed to allow the brain to have a place to go other than downward and into herniation. Once the swelling is reduced, and intracranial pressure stabilized, the skull will be replaced, and bone will grow back, protecting the brain again. They do place the removed part into the abdomen so that the bone does not die, but is still inside the skin, and can be used again later for the replacement.
Another reason for removing the skull piece is to evacuate blood and other fluids from a site of bruising and/or bleeding. This itself creates pressure, and can also cause a herniation of the brain downward.
As for her swallowing, that may be temporary. The gag reflex is not located where the language area is, and is ennervated by nerves in the base of the skull which go through the palate and into the throat. (Cranial nerves IX or X). Depending on which nerve was damaged and where, either sensation is destroyed or motor function is destroyed. However, if there is swelling, and over time the swelling reduces, and the swelling has not caused necrosis and/or neuronal death (meaning it still can work, it just is "stunned" into immobility), the chances of her regaining the ability to swallow is there.
When the Drs say she can't communicate, I don't think they're being precise. She may not be able to speak (some of the same nerves used there as in the gag/swallowing reflex), but her shaking her head no means a great deal: she comprehends language, and has retained an alternative method to communicate. The speech area of the brain is called Broca's area, and is located on the left side, just above and behind the ear.
She understands. She communicated her "no" apparently quite clearly. So I'd say she can communicate. Also, some recent findings have shown that Broca's area, long thought to be the only area of speech, is not necessarily so. In some patients with Broca's lesions, the ability to speak has been recovered over time, as the brain retrains and relearns. Difficulty in speech remains, but it is no longer a given that if one has Broca area damage, it is both permanent and irrecoverable.
Her ability to comprehend speech, to me, is more important. For her to be able to interact with her environment is precious, precious, precious. That is huge, and her retaining the ability to understand spoken words and respond appropriately to them is an incredible indication that there is hope for her future. Given time enough and good care, she may well continue to surprise everyone with her healing and recovery.
And Treacy can rot in hell.
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