SIENA, Italy -- Italian auto racing champion turned Paralympic gold medalist Alex Zanardi underwent a second brain surgery Monday, 10 days after an emergency operation following a crash on his handbike.
The latest surgery lasted more than two hours, after which Zanardi was returned to the intensive care unit in a medically induced coma, the Santa Maria alle Scotte Hospital in Siena said in a medical bulletin.
"His condition remains stable from a cardio-respiratory and metabolic viewpoint, grave from a neurological viewpoint," the hospital said.
Roberto Gusinu, the hospital medical director, said, "The operation that was done represents a step that was foreseen by the medical team."
The 53-year-old racer, who lost both of his legs in an auto racing crash nearly 20 years ago, has been on a ventilator since he crashed his handbike into an oncoming truck near the Tuscan town of Pienza on June 19 during a relay event.
Zanardi suffered serious facial and cranial trauma, and doctors have warned of possible brain damage.
Zanardi won four gold medals and two silvers at the 2012 and 2016 Paralympics. He also competed in the New York City Marathon and set an Ironman record in his class.
Last week, Pope Francis penned a handwritten letter of encouragement assuring Zanardi and his family of his prayers. The pope praised Zanardi as an example of strength amid adversity.