Dr. Dave Rosser of Birmingham's Queen Elizabeth Hospital said that 15-year-old Malala Yousufzai needs the operation to replace the bone shattered when a Taliban gunman, angered at her objection to the group's restrictions on girls' education, sent a bullet through her skull. Rosser said that Malala had made a "remarkable recovery."
"She's very lively, she's got a great sense of humor," Rosser told journalists at the hospital. "She's not naive at all about what happened to her and the situation she's looking forward to in terms of being a high-profile person, and potentially a high-profile target. She's not naive to any of that, but she remains incredibly determined, incredibly cheerful and incredibly determined to speak for her cause."
That cause has turned Malala into a symbol for a girl's right to an education.
At the age of 11, she began writing a blog under a pseudonym for the BBC about life under the Taliban in Pakistan's picturesque Swat Valley, which Taliban militants briefly overran. After the military ousted them in 2009, she began publicly speaking out about the need for girls' education. She appeared frequently in the media and was given one of the country's highest civilian honors for her bravery.
Malala was shot on Oct. 9 as she headed home from school. The Taliban said they targeted her because she promoted "Western thinking," but the attempt to murder a teenage girl over her desire to go to school sent a wave of revulsion around the world. Amid a blaze of publicity over her plight, Malala was flown to England for advanced medical care - and for her own protection.
There was no indication Wednesday of whether or when she would return to Pakistan, although Rosser said it would likely be a year or 18 months before she made a complete recovery.
"Anybody who's required a lengthy intensive care stay or undergone significant neurological injuries, studies tell us people don't report feeling as well as they used to for 15 to 18 months," he said.
Rosser went on to give a detailed briefing of what Malala could expect from the surgery, planned for some time within the next two weeks. He said doctors also have to remove a piece of Malala's skull that they had surgically inserted into her abdomen - a common procedure intended to keep the skull fragment from getting infected. Eventually, however, surgeons opted for a titanium plate to cover the hole.
A cochlear implant is also being implanted and will be turned on in about a month's time. Rosser said it should eventually restore her full hearing.
Asked whether Malala showed any signs of brain damage - such as memory loss or hormonal changes - Rosser said doctors had seen none.
Barring any complications, he said the skull reconstruction should be Malala's final surgery.
"She's certainly pleased with the thought that this will be the end of it," Rosser said.