Second brain surgery performed on Emilio

HOUSTON (AP) - Doctors worried about the condition of entertainer Emilio Navaira, gravely injured in the crash of his tour bus early Easter morning, said Wednesday they returned the Grammy-winning Tejano singer to surgery to relieve growing pressure on his brain.

Navaira, 45, known to his fans simply as Emilio, underwent another nearly two-hour operation Tuesday evening, his second such operation in two days.

"The pressures in his brain started to creep up a little bit, never became critical, but during the course of the day they seemed to be responding less and less well to some of the medicines we were giving," said Dr. Alex Valadka, director of neurotrauma services at Memorial Hermann-Texas Medical Center and vice chair of neurosciences at the University of Texas Health Science Center at Houston.

He said he reopened an incision made during Navaira's initial surgery Sunday and removed a piece of bone that had been taken out and put back following that first operation to remove a blood clot.

"After the surgery, the pressures in the brain were lower and Emilio tolerated the surgery fine without any problems or complications," Valadka said.

He said Navaira remained in critical condition but described him as improved and "perhaps better off than he was a few days ago."

Navaira was thrown through the windshield when the tour bus he was driving crashed on a Houston freeway as he and his band were returning home to San Antonio following a Houston club date.

The wreck remains under investigation and left several members of Navaira's band, including his brother, Raul, with less serious injuries. They've released more than a dozen albums, including "Acuerdate," which won the Grammy for best Tejano album in 2003.

"He is still in a coma," Valadka said. "We are still giving him some medication so it's difficult to say at this point how much is from the severity of his injury and now much is the medication. If he continues to remain stable, we'll gradually try to cut back some of the medication."

He said recovery could take months.

"The general pattern with someone with injuries of his severity, you think of prolonged recovery, rehabilitation and a lot of therapy," he said.

The neurosurgeon said his team decided to remove the piece of his skull in the most recent operation after an examination showed the pressure increase was caused by bruising to the left side of his brain in an area close to the part that involves speech, particularly understanding speech.

"We thought about it quite a bit and had a lot of discussion and decided best thing would be to take off the skull and not try to disturb that part of the brain at all," Valadka said.

Raul Navaira said he went to sleep on the bus after their show, then was awakened about 5 a.m. Sunday when items on the bus began falling on him. The next thing he knew, he said he was getting off the bus and saw his brother being taken by paramedics to an ambulance.

"I just shouted out that I loved him," Raul Navaira, 40, who suffered an injured ankle and bruises, including a black eye, said Wednesday.

He said he's seen pictures of the wrecked bus with its front crushed.

"I know it's not good," he said. "Maybe he's still with us because he was ejected, because that part of the bus was really messed up."

He also thanked all the medical people for their help and supporters from around the world for the messages and prayers.

"It's phenomenal how many people loved my brother and are praying for him," he said. "I just want to tell everybody I love you all for supporting us, for sending us all your prayers. We can feel them. We've got to imagine my brother getting better."

Police in Bellaire, the Houston enclave where the crash occurred at the interchange of Interstate 610 and U.S. Highway 59, said Navaira was not licensed to drive the 26,000-pound tour bus. Authorities were awaiting the results of blood-alcohol tests and said it was possible he may have fallen asleep when the bus struck a configuration of barrels that separate the freeway from a ramp.

Raul Navaira discounted the possibility of fatigue.

"We're used to it, every weekend," he said. "We're used to driving all over Texas. It was like any other night."