Shot Pakistan schoolgirl standing up in UK hospital

Speaking outside the hospital, its medical director, Dr Dave Rosser, told reporters: "It's clear that Malala is not out of the woods yet.

"Having said that, she is doing very well. In fact she was standing with some help for the first time this morning when I went in to see her."

Dr Rosser, medical director of the University Hospitals Birmingham NHS Foundation Trust, said Malala was happy for him to share details of her clinical care and wished to thank people around the world for their support.

In his latest briefing on the schoolgirl's condition, he said she had the potential to make "pretty much a full recovery" but may not undergo reconstructive surgery for at least two weeks.

"Malala is still showing some signs of infection which is probably related to the bullet track, which is our key source of concern," he said.

Although Malala is currently unable to talk due to a tracheostomy tube, Dr Rosser added: "She is communicating very freely, she is writing.

"Her airway was swollen by the passing of the bullet, so in order to protect her airway she had a tracheostomy tube.

"She is not able to talk, although we have no good reason to think that she wouldn't be able to talk once this tube is out, which may be in the next few days."

Giving details of the bullet wound - which came within inches of causing death - Dr Rosser said: "Malala was struck just above the back of the left eye.

"The bullet went down through the side of her jaw, damaging the skull and the jaw joint on the left hand side… went through the neck and lodged in the tissues above the shoulder blade.

"The bullet grazed the edge of her brain. Certainly if you're talking a couple of inches more central, then it's almost certainly an unsurvivable injury."

Dr Rosser added: "Malala is keen that I thank people for their support and their interest because she is obviously aware of the amount of interest and support this has generated around the world."

The Queen Elizabeth Hospital, which cares for soldiers with gunshot injuries flown back to the UK from Afghanistan, said earlier that Malala had spent a fourth "comfortable" night in Britain and was being assessed by specialist consultants.

The teenager, who was attacked after promoting the education of girls and criticising Taliban militants, was initially treated by neurosurgeons at a Pakistani military hospital before being flown to the UK.

She was shot with two classmates as they made their way home from school in north-west Pakistan, in what Foreign Secretary William Hague described as a "barbaric attack".

The nature of Malala's injuries suggest she was shot from above at point-blank range.

The bullet, which was removed by surgeons in Pakistan, hit her left brow but, instead of penetrating her skull, travelled underneath the skin along the whole length of the side of her head and into her neck.

Shockwaves caused by the bullet are thought to have shattered the thinnest part of Malala's skull, driving fragments into her brain.

A titanium plate or a piece of her own bone may be used to perform the reconstructive surgery, which will not take place until after a period of rehabilitation and that could take weeks or even months.

Although Malala was not conscious when she arrived in Birmingham, she emerged from a medically-induced coma on Tuesday afternoon.

The attack caused damage to Malala's brain, Dr Rosser said, but she is able to write, is aware of her surroundings and what has happened to her, can move her arms and legs, and can stand up with assistance from nurses.

It is also known that the teenager, who is not on a ventilator, asked nurses what country she was in when she came out of the coma.

Dr Rosser told reporters: "There is every sign that she understands why she's here.

"It's a very difficult position for her, clearly, because she has gone from being on a school bus and the next thing she will be consciously aware of is being in a strange hospital in a different country.

"She seems to have understood why she is no longer in Pakistan and what has happened to her."